BC Cal - MRMIP

I just signed up with MRMIP - Blue Cross PPO.  I visited other lapband sites & am reading horror stories about Blue Cross California PPO.  I have read that the insurance requires at least a 6 month supervised diet, others said it is 18 months.  I rad over the medpolicy and although it is vague, it does not specifically say that a supervised diet is required. Is anybody familiar with MRMIP?  how about Blue Cross PPO California. I have a 3 month pre-exsisting restriction so I cannot see my in-network surgeon until April. I also read..."just because a surgery is approved, it does not mean that payment for that surgery is guaranteed..." I have been in 3 obesity clinical trials in the last 3 years. I have had blood drawn, EKGs, bi weekly weigh ins and seen a nutritionist regularly in the last two. I am freaking out here...please give your opinion! -------------------------------------

1. BMI of 40 or greater, or BMI of 35 or greater with co-morbid conditions including, but not limited to, life threatening cardio-pulmonary problems (severe sleep apnea, Pickwickian syndrome and obesity related cardiomyopathy), severe diabetes mellitus, cardiovascular disease or hypertension. AND *Note: Individuals considering the laparoscopic adjustable gastric banding (Lap-Band®) procedure must meet the above minimum BMI requirement and, in addition, have a maximum BMI of less than 50.
2. The patient must have actively participated in non-surgical methods of weight reduction; these efforts must be fully appraised by the physician requesting authorization for surgery. AND
3. The physician requesting authorization for the surgery must confirm the following:
   • The patient’s psychiatric profile is such that the patient is able to understand, tolerate and comply with all phases of care and is committed to long-term follow-up requirements; and
   • The patient’s post-operative expectations have been addressed; and
   • The patient has undergone a preoperative medical consultation and is felt to be an acceptable surgical candidate; and
   • The patient has undergone a preoperative mental health assessment and is felt to be an acceptable candidate; and
   • The patient has received a thorough explanation of the risks, benefits, and uncertainties of the procedure; and
   • The patient’s treatment plan includes pre- and post-operative dietary evaluations and nutritional counseling; and
   • The patient's treatment plan includes counseling regarding exercise, psychological issues and the availability of supportive resources when needed.

I'm am no expert by any means, heck I haven't even had surgery yet but from what I have read your req's are really normal! That is a good thing, Sounds like you have a TON of history in the attempted weightloss area. All you can really do it follow there rules talk to the dr's and have a litte faith! Good Luck! Rebecca