Weigh****chers online insurance question

Hi everyone! Although this is my first post, I've been stalking for a few weeks. I am 34 and hovering right around 240 on a 5'6"ish frame. I have high blood pressure that I take meds for, sleep apnea and use a CPAP, going in for an ultrasound on my liver this month because of recent blood work that indicates I probably have fatty liver disease and bad cholesterol. So needless to say my body does not like being overweight. My BMI is between 38-39 depending where I do the calculations.

So my question is, I have Anthem Blue Cross/Blue Shields PPO and I have already read the requirements to be considered for bariatric surgery. Does anyone know or have experience with weigh****chers online as the requirement for the weightloss program and it counting towards a failed weightloss program? I have logs for the past 8 months.

Thanks in advanced. My first consult is the 18th of this month.

Hi there,

i had anthem blue shield ppo was not required to show anything. You surgeon should know more about what you will need for requirements

Oh great news, hopefully it's the same. I'd really like it to be a smooth process but we'll see. Glad I found this site though! I'm sure I'll be here a lot.

Every employer has their own requirements for your health insurance program. Millions of people have Anthem BC/BS (as I do), but each plan is unique depending on what the employer puts in the coverage. The only way to know for sure is to call the number on your card and ask them the specifics of what YOUR plan requires; they're the only ones who can tell you if the WW program counts or not.

Most bariatric centers have their own requirements, which are in addition to the ones your employer-sponsored insurance plans have. So you may want to contact a variety of centers to find out this info before deciding which one to sign up with.

My insurance called for six months medically supervised plan and I had to go to my surgeon's office to do it. In addition I filled out a form showing every program I had ever been in with starting and ending weights. Most insurances will not qualify under 40 unless you have Type 2 Diabetes.

Whether they approve for the high blood pressure and cholesterol depends on what drugs you are taking and proving that the drugs fail to bring the conditions down. The fatty liver disease will depend on your blood test records.

You are right on the edge of what qualifies, so see what happens with your consult. A lot will depend on how well your surgeon's insurance specialist works with your insurance company and with your policies specifications.

If you do not qualify for insurance coverage, you can still explore self-pay either in the United States, or medical tourism.

It's all going to depend on your specific policy, as well as your surgeon. Some places don't count Weigh****chers or any other online plan because your weight is self-reported; for all they know, you could have fudged the numbers.

If in doubt, call the customer service number on the back of your insurance card and ask for specifics.

Thank you all for the responses. I have my first consult on the 18th then another on the 21st. I am very excited to start this process. I will be calling my insurance tomorrow to see if I can get any details on requirements. I like to be overinformed!

I have Anthem and I did have to do 6 months of medically supervised weight loss (I'm 2 months into it right now). I don't mind it, as it is giving me an opportunity to learn to eat right. I just have to have an appointment with the bariatric surgeon's office once a month where I weigh in and have a short chat with the nurse practitioner there about how things are going.

They can run this concurrently with all the other preliminaries (psych consult, EKG, chest x-ray, nutritionist, any other consults your surgeon and/or insurer requires).

It does push my surgery into next year, with a new deductible and out-of-pocket max to meet, which kind of sucks though.

My surgeon told me- under 40 BMI co-morbidities the insurance companies look for Type 2 diabetes, High blood pressure and Sleep Apnea.

You never know until you are approved but it sounds like you have the basic criteria.