BCBS of MI?

I live in Missouri, but have BCBS of Mi (PPO). One of my requirements is a 12 month supervised diet. I notice alot of you have gotten approved without this. How did you do it? I started a supervised diet in November, but was hoping to have surgery this year since my yearly deductible has already been met. Any suggestions? Thanks!!

I have BCBS and some comorbidities and there was no way of getting around the 12 months, at least with my policy. It may be possible for you to still get the surgery this year, just keep on top of your appointments and meet with your surgeon well in advance! I met my surgeon in December and he said it would be about 6 to 8 weeks after that and sure enough, I had my surgery in February. Hang in there. Tiffany

I also have BCBS of Mi, and they allow you to use Weigh****chers or Tops to count as your supervised diet. Have you ever attended one of these in the last 3 years? I was approved using TOPS. And my surgery is scheduled for May 16.

Hi Shonna, All I had to do was have my PCP send in a letter and copies of my records that for at least the last year we had discussed my weight at different appointments. Yes, I had tried Weigh****chers and such but not for a full year. He sent in my records and whatnot and I had no problems. I was approved in the first try. Also, with BCBS PPO, if your PCP and the surgeon feel you meet the requirements, then no pre-approval is needed. At least this is what my policy states and I have heard it from others as well. Good luck, Danielle

Hi Shonna (and Danielle), I have BC/BS PPO so I don't know if your policy and mine would be the same. Anyway, as Danielle stated, I too had my PCP send a letter that stated all of the weight loss medications that we had tried and that I "followed" a weigh****cher diet CONSECUTIVLEY for the past 12 months. This is the KEY word for Blue Cross...CONSECUTIVLEY. My PCP was working with me since 2003 before I told her that I have had enough of the trying different drugs and food plans that were just not working out. We both agreed that I had exhausted my options and that I was a good candidate for WLS. They (BC/BS) didn't require any documentation from weigh****chers (not that I shouldn't be a lifetime member of weigh****chers by now because I have joined and quit so many times. If I would add up all those times it would have easily added up to many many many years) But that is not the point, they just wanted to know that for the past 12 months I was doing my part (which I was) and that was good enough for them...approved first time, first letter, within two weeks and no problems. I think that they are realizing that in the long run this will be much less expensive to pay for the surgery versus the complications that obesity causes for people. As for your deductible...valid concern. Do you have a pre tax flexible spending account offered by your employer or spouse's employer? My husband does and we use it for our deductibles and co pays through out the year. Our benefit company even issues a Visa card for our account and our pre paid money in it so that you can use it at hospitals and doctor offices. It is the best plan that we have ever had. They are becoming more and more popular too so check into it. Hope this helps! Sandi - Cadillac, Michigan

I have BCBS of Michigan also. My doctor had to send a letter to the surgeon before surgery. We had talked about diets at least once a year - I would loose and gain. I guess that worked for BC. My surgeons office took care of all of the approval stuff - they were wonderful - I never had to worry about any of it. Good luck...