Hello, I recently found this on the net. Does anyone know what this means? I know I have been to my doctor in the past for help with my weight but was not eligible for weight loss pill because of my heart, also I have years of documentation that ive been obese. So does this mean I do not have to wait the 6 months? am I eligible in 3? has anyone done this? Thanks! :)

"Per Policy Bulletin S-131A insurance requires BMI of >35 with at least one co-morbid condition, minimum two year history of morbid obesity, 6 month PCP diet or 3 month multi-disciplinary diet, exercise and behavior modification program with neither supervised by the surgeon and psych evaluation.  Sleeve and StomaphyX are investigational and not covered."

Yes, I'm familiar with all this.  My surgery was "covered" by Medicare and they had the same qualifications.  I called them on the phone and got all the information, did everything they required and jumped through ALL their hoops.  Surgery was scheduled and done.  After, Medicare refused payment!  It was appealed 3 times, and finally covered, somewhat!  They had also stated if you lost more than 10% of your weight, over the 6 month period of Dr. weight checks, that you'd NOT qualify for the surgery.  Get all your "ducks" in row, start getting your Dr. weight checks, monthly.  Schedule your nutritionist and psychological evaluation, asap.  Before you know it, all will be done and you'll be on the way!  DON'T LET ANYTHING STAND IN YOUR WAY!

Ginger

even though you ahve been seen by the dr for a good amount of time for the pp people you have to be seen every mth for just weight issues for six mths. nothing more. trust me when i say this i just finished jumping through hoops for them. if you have seen you dr for six mths for weight only then you dont have to do the six mths again. if it wasnt for that little sitpulation i would have had the surgery six mths ago.