Insurance & 6 months diet

Hi, I have started the process for gastric bypass in Aug, and got my first denial from the insurance company (Blue Cross of Southern California - PPO) 2 days ago,they are requesting 6 months of documented diet and excerise program. I am really down in the dumps now...My BMI is 41. I am 49 years old and have been on different diets since I was 10, and I feel that I don't have time to waste anymore on this diet and that diet, while my health is getting worse. My problem is not that I eat wrong types of food, but rather eat too much of the good things. what is the best thing to do? should I appeal or should I just go to my doctor to start the 6 months as soon as possible?

I would go to my primary and start the 6 month diet immediately. If you have been to a primary doctor recently about your weight see if they will backdate from there. Then if there are other solutions like appealing or whatever you can do that. But at least you now have a start date for the diet. I wish you the best and hope you can get this appealed.

BCBS (and most insurance companies) require the 6 months documentation. I have BCBS of NY and they did require it but asked for it when my claim was submitted. So until I had that documentation I wasn't approved. If you have been to your PCP each month in the last 6... maybe they can provide their medical notes for your as documentation.... or at least the last few months. Good Luck!

Hang in there. I know exactly how you feel. I thought I needed only 3 months of diet and exercise then I found out it was 6 months. I was devistated! I wanted the surgery and I wanted it now!! I was 300 lbs and 48 yrs and had researched the surgery for 2 years. Dont miss any appts..and dont let your Dr postpone any appts if at all possible. It will happen. I had my surgery last June and now weigh 188 lbs. Its amazing and well worth waiting for. I hope in the future that the 6 month requirement will go away. The surgery has been so beneficial to so many. To me it was just a waste of time and ins money (and my money) Hang in there and get all the other required tests done in the mean time. You can do it!! Best wishes! Sally

I work with insurances and believe me....If you haven't met their criteria then it won't happen! .... Start the supervised diet asap!!!! Sometimes PCP's will use past month's chart notes to boost you along. It's very important that the 6 months are consecutive though or you'll have to start over! Just think that you could be appealing for 6 months and getting angrier and perhaps even heavier OR....you can jumping through the 6 month hoop....while getting all the other hoops on the list finished. A good Bariatric Coordinator will have you all complete and ready to submit the very day you finish up your 6 month diet attempt! Hang in there! Joyce

Definately start the diet. I started my diet, and kept working at other options. In the end, my insurance accepted 6 months of proof of gym membership.