6 month diet for BCBS
Can anyone give me any insight on this 6 month medically supervised diet required by BCBS? Currently my BMI is 42....if I lose weight on this diet and fall below 40, could they deny my surgery? I don't have any obesity-related medical issues such as high blood pressure, diabetes, etc. which BCBS allows you to have a BMI of 35 and be approved for surgery.
Most insurance companies use starting BMI. I have United Healthcare and they also require the 6 month supervised weight loss. My BMI dropped below 35 but they still paid because I qualified at the BMI I started at.
Liz 5'3" HW: 219 SW: 185 GW: 125 LW: 113 Desired maintenance range: 120-125 CW: 119ish
I was very careful not to let my BMI get out of the accepted range during the six month pre-op diet.
Why take a chance on being denied, when we all know that the pre-op weight will be quickly regained if there is no surgery?
Insurance companies are staffed by human beings. Some will be compassionate, others will try to save the company money by denying you coverage because you demonstrated that you no longer need surgery,
Real life begins where your comfort zone ends
White Dove has a good point. My surgeon's office didn't "officially" record my last weight (where I went under) because of the risk even though UHC said that it was the starting one that counted - that last weighing was done after approval and just before surgery, so I was 35 or higher for all recorded weights including those submitted for approval. I was lucky that all went through ok.
Liz 5'3" HW: 219 SW: 185 GW: 125 LW: 113 Desired maintenance range: 120-125 CW: 119ish
I have Fed BC/BS and was required to do the same 4 years ago. They do it partially to know that you are committed to the process and lets be realistic you probably aren't going to lose that much in 6 months, because if you could have done it that way you already would have!! Is part of the game we have to play...
I had to do 3 months for Cigna. My doctor's weight loss program was, "Eat better, exercise more, and don't lose any weight." In other words, don't change anything. Lol. He thinks the whole game is stupid and a waste of time. My weight did fluctuate during the 3 months, so it kind of showed the insurance company that I was trying, but it wasn't working. Good luck! I think you'll be fine!