? on BCBS IL 6 Months of Diets

I have BCBS of IL. I am confused about the six months of supervised diets. The policy does not state that it has to be consecutive. I called BCBS and asked them and the rep told me it did NOT need to be 6 consecutive months. It simply states 6 months within a 24 month period. I meet with my surgeon today and spoke with the insurance coordinator at the center. She told me that it had it said in the policy consecutive. I told her no it does not. She seemed certain to show me up and prove me wrong BUT when she pulled it out she was like you are right it does say consecutive months. I was wondering if anyone had any experience with getting approved withot the diets being consecutive. I have 3 months consecutive then 3 months off and 3 months on then 2 months off...2 months on. Losing weight..gaining it back. What are my chances of approval?

Hi, I did not have to have any supervised diets, I just had to show where I had been dieting within the previous 5 years. (WW ,TOPS,
ect.) But I had BSBC Anthem, not Illinois. Every company writes in what they want, so everyones insurance is different. Even within my husbands Co., There are at least 3 different policies. Try to get whatever you need in writing from your HR person, or the insurance  person. That way you have something tangible in your hands.

Good Luck

I have BCBS of IL PPO and mine had to be consecutive or they would make me start the 6 months over...
I would get the name of the person you spoke with at the insurance company and document everything that was said and the dates and times...don't mess with insurance companies, they can and do make our lives a living Hell sometimes....
good luck

I have BCBS IL PPO and I had to do 6 consecutive months.
If your paperwork doesn't say consecutive and the person you talked to says not consecutive, journal everything, persons name...what they said...date...

I agree with everyone else.  DOCUMENT, DOCUMENT, DOCUMENT.

You can submit with what you have and point out to them that the word "consecutive" is not in YOUR policy.  If they deny you, then you have to PROVE to them that YOUR policy does not say "consecutive".
BUT, I know that they can be very particular about the supervised diet and prefer 6 consecutive months.  They will even go so far as to say it doesn't count if the visits are too close together or far apart.  (Example:  less than 21 days, more than 45 days between appointments).

Good luck!

I would call the insurance comp, and ask them to send you info about the required months. I have BC/BS  IL, and mines have to be a consecutive 12 months. only on month eight. I wish I did only have to do six !

Dear Friend,
I would say your chances of approval are 100% either sooner or six months down the road.
I know the wait is very hard. I had BCBS of MN and they required six months of consecutive.  At first I was upset because I had been seeing my dr for years and he had recorded my attempted weight loss but as I worked thru the months with my bariatric group I began to see the wisdom of doing all this.  You already have a year of documented success and failure.  You say yourself,
3 months on 3 months off. The insurance companies are not looking to turn you down they just want to be sure you will not go thru all this just to go back to your old patterns.

Everyone here on the forum will tell you that you have to dedicate yourself to this...long term.
It is only a tool the real battle is in the mind. So try for approval but work for successfully following the pre surgical rules, it will make it easier afterwards.

Best wishes and good luck.

I have BCBS illinois HMO..I think alot depends on your surgeon, and also your group.I had Sherman Choice for my group...and my primary care doctor told me that they will not approve the band because they still consider it experimental.  I talked to my friend who has bcbs Illinois who has the band now for about a year and a half,,,but her group is Health Select..Called bcbs changed my group, then asked my doctor for a referal to the surgeon....My surgeon told me that since I have the same primary care doctor for more than 6 years, I did not have to take any tests, or have a 6 month diet. He said that my doctor has been supervising me and if he felt I was a good candidate for the band that was good enough. He told me he would do his best to get me approved...and he did.  The insurance first denied me but he sent a more detailed letter and I was approved.  I think it took me about 4 months from my consultation until my surgery, and it could have been sooner, but my surgeon was on vacation for 2 weeks and plus I had to psych myself up for it.

   I think if you are having problems try to talk to someone who you know who has had to go through it...maybe attend one of those seminars. Every doctor, every surgeon, and every hospital is different.

 Good luck to you in your quest..
   Joy

I forgot to say...If it does take 6 months of supervised dieting or even 1 year it is well worth it.
Also if you lose too much they will not approve it because they say you can do it on your own...

Each time I do I diet I lose about 30 and gain back 40. Just tired of the yo-yoing back and fourth.