BMC healthnet, anyone?

bras1987
on 2/11/13 9:17 am

Hey!
I just had my first visit with the surgeon, and they are a little worried about my insurance part (BMC healthnet - Commonwealth Care), where it says: "Continued obesity despite previous efforts at nutritionally and medically sound weight loss that have been tried and failed for a minimum of 6 months as documented in medical records".
My Dr think i will have to do a 6 months under a nutritionist supervision before going thru the surgery,they even gave me the idea of purchasing a private plan to do the surgery,  but i called BMC and they said that i only need "proof" that i failed treatments or programs before (like WW, etc). I did have another weight loss surgery in 2007 called BIB in Italy, which did not succeed, and also did 1 whole year of ww in 2010, and gained all the weight back.

DId any of you dealt with this before? My BMI is 43.

 

Should i go forward with BMC or should i buy a new private policy?

 

thanks

 

 

M. Mara
on 3/1/13 7:22 am
On February 11, 2013 at 5:17 PM Pacific Time, bras1987 wrote:

Hey!
I just had my first visit with the surgeon, and they are a little worried about my insurance part (BMC healthnet - Commonwealth Care), where it says: "Continued obesity despite previous efforts at nutritionally and medically sound weight loss that have been tried and failed for a minimum of 6 months as documented in medical records".
My Dr think i will have to do a 6 months under a nutritionist supervision before going thru the surgery,they even gave me the idea of purchasing a private plan to do the surgery,  but i called BMC and they said that i only need "proof" that i failed treatments or programs before (like WW, etc). I did have another weight loss surgery in 2007 called BIB in Italy, which did not succeed, and also did 1 whole year of ww in 2010, and gained all the weight back.

DId any of you dealt with this before? My BMI is 43.

 

Should i go forward with BMC or should i buy a new private policy?

 

thanks

 

 

Hi!

Sorry I cant answer you, did they approved you? I have BMC , and Im in the beginning of the process...hope u answer me1

bras1987
on 3/1/13 7:34 am

Hey, i changed to NHP as bmc were asking 6months diets before approving. Nhp does not require that, but my surgeon officenis sending the request for the prior authorization monday. Hopefully they will aprove me! 

M. Mara
on 3/11/13 1:32 am
On March 1, 2013 at 3:34 PM Pacific Time, bras1987 wrote:

Hey, i changed to NHP as bmc were asking 6months diets before approving. Nhp does not require that, but my surgeon officenis sending the request for the prior authorization monday. Hopefully they will aprove me! 

HI!!!

How about the process??? did you approved? I would like to know, maybe I will change to NHP, my concern is my BMI, I have 35 with Diabetes 2 and prehypertension..... Let me know!!! Good luck!

jugilber
on 3/25/13 5:04 pm - MA

Hey All...

I had my surgery at BMC...I had Harvard Pilgrim and had to "prove" I tried and failed diets...it was easy...a few receipts from WW and it was approved...are you going to BMC for your surgery...because maybe the approval will be easier.

 

         
bostonbabe369
on 3/26/13 6:24 am - Stoughton, MA

I met with my surgeon yesterday. I have Commonwealth Care Network Health. I will be having my surgery performed at St. Elizabeth's Hospital. My insurance doesn't require any proof of past weight loss attempts or five years of medical history. I am so happy! I don't have any of these and I thought there would be a delay or problem. I can even go to my own psychiatrist. The only thing I need to do is complete a few more test and lose 25 pounds. I am hopefully on my way!

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