Anthem BC/BS PPO
My insurance company is out of Colorado, I live in MI and have their PPO plan. I have called them 5 times to make sure I know what the criteria is for WLS. I have been told the following each time I call, BMI of 40 or 35 with co morbidities, actively participated in previous diet attempts, psychiatric evaluation, letter of medical necessity from PCP, surgeon to confirm an acceptable candidate for surgery, and pre and post op nutritional counseling. No one ever said 6 or 12 month medically supervised diet. My surgeons office is telling me that they think my insurance DOES require this. Does anyone have Anthem and been approved for WLS. If so, what criteria did you have to meet to be approved?