kleynam

I'm hoping that everything goes through, with mine.i HAVE bcbs. I have 5 DR. notes saying that I either need or "it would be beneficial to her health" or some bull like that. I have BSBC, i do have six months of dieting but I would have to dig for it. I'm alos lucky on the deductable part. I'm under my parents till I graduate College or turn 25, and my sister alone met the deductable in May. So I don't have to worry about that.

SueRN

You always have to check with what specific coverage you have....even if you have the exact same insurance company as another person. Not all BCBS's are the same. Each has their own set of medical policies. And, there are certain employers that add add'l requirements and/or limits to coverage for WLS. I used to work for BCBSNC and my job was to review WLS. BCBSNC was one that did not require a MD supervised diet plan. I had Highmark BC out of PA when I had my surgery. They require a 6 month MD diet within the preceding 2 years of applying for the surgery. I'm not saying not to ask other people about their coverage, but you need to find out about your own benefits that are specific to you. It will create less confusion and heart ache.

I also suggest that before you even consider WLS, check out your benefits first.

I had to weight 1 year from my first appointment till I had my surgery back in 2005. It was frustrating but I had to do another 6 month diet. The other 5 I had done in my life didn't matter because they weren't done in the previous 2 years. But, I decided that I wanted this surgery and was going to do whatever I needed to to get it. I also took a positive attitude and used that year to start the changes and healthier life style that you will need for long term maintenence. So, it actually worked to my benefit. I was well prepared for my surgery. This is about life style changes. The surgery is such a small part of the plan in the long run. Yes, it will help you to lose weight, but if you can't diet now or do what you need to do to make these changes now...you will have a hard time keeping the weight off.

Even now, I still struggle with 15-20 lbs. I go up and down. But I always have to watch what I'm eating and always have to exercise to keep the weight off. This isn't a quick fix and those that have had the surgery will tell you that. Would I do it again? In a NY minute. This was the best thing for me, but it's hard work. And what it comes down to after the surgery is diet and exercise. So yeah....that 6 month diet is actually a good thing which will help you in the long run. Best of luck to all of you. If you have any insurance problems/questions....don't hesitate to PM me! Sue

adagirl

Awesome!!! BCBS really seems to be the best. I'm glad to see insurance companies reducing the hurdles to this surgery. I did the diet for Aetna and was really bummed at first that I had to do it. But, I was able to do it through my bariatric surgeon's office and it turned out to be really helpful because instead of just another traditional diet, their nutritionist actually used that time to teach me about how I will eat after surgery and making new habits that will help me after the surgery (such as protein first, sipping water all day, no more carbonated drinks, exercise every day, etc.). And, honestly, I needed that time to get my head around all of this. But, I don't like that it was an insurance requirement. I just feel like the insurance companies aren't doing it to help you, but using it as another opportunity to deny you or make it so much trouble as to make you want to give up.

Now, I'm battling over Aetna because they require a 2 year weight history and I happened to have been doing good on Weight Watchers 2 years ago. So, I had to dig up all these older records to show obesity well past 2 years. I just feel its so stupid and they are just using this as a way to deny me. I have a BMI of 40 and FOUR co-morbidities now. I only had TWO when I started this process. From what I've heard BCBS doesn't require the weight history either. Hopefully all these insurance companies will improve their policies because a lot of the requirements (weight history and 6 month diet) really aren't relevant. Its the BMI and co-morbidities that predict if you are headed for heart disease. And, the cost of weightloss surgery is a drop in the bucket compared to what it would cost them if I had a stroke or needed heart surgery.

gooberific

Of course, if they covered gym membership and personal trainers, they'd save even more money in the long run.

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