What constitutes 12 month diet

SherylN
on 7/6/07 11:56 am - West Bloomfield, MI
I have BCBS of Michigan.  They require a 12 month Dr supervised diet.  What exactly are they looking for?  I have been on Meridia for over 2 years and have gone to my PCP every 3 months to discuss diet, weight, and exercise.  Would this qualify? What does BCBS require as support? I am going to my PCP on Tuesday and hope to gather everything I need.  Any advice is appreciated.  Thanks bunches. ~Sheryl
missdei07
on 7/7/07 2:51 am - FL
I have BCBS of Mi too....and am having a TIME with them...you can read my post "I need help....Gary do I need a lawyer?"  When I called to ask about the 12 month diet, they told me any documentation that I had of diets that I had done in a year along with a drs. note was fine....however the surgeon said that they need 12 consecutive months of you going to the pcp and being weighted and discussing diet, exercise, etc. Call them and specifically ask them what they want as far as diet is concerned, try to get it in writing. I have been trying for three months and havent been able to get anything but if you have a helpful surgeons office who is willing to battle with this company, you should be fine. Hope you have a better time with them than i am having.

   "Where there is no struggle..there is no strength."
timewellspent.jpg

erinv
on 7/7/07 10:54 am
I had BCBS of Michigan before i moved to texas, and started the 12 month Dr supervised diet.    I had to be weighted every month and have documentation that we discussed diet and exercise. I don't think that 2 year history would work since you did not get weighted every month. I did 8 months of this before I switched jobs and moved out of state.  When I got to TX i called all of my insurance choices and found the one with the least hopes, and had the surgery in May. I would suggest, start doing it every month, while you do the rest of your pre-op testing, then if they denied it you already have a few months in.

SCushway
on 7/7/07 1:31 pm - Daphne, AL
I have BCBS AL and mine required a monthly check-in with a Primary Care Physician.  I only have to be on a physician supervised diet for six months but it has to be a legit diet plan (i.e. your Meridia)and has to be documented every single month.  I am going on my third month now. You may want to try with what you have been doing, all they can say is no and who knows, they may accept it.  Discuss it with your surgeons office. They typically know how the various insurances will respond based on experience with dealing with them.  But in the mean time, start seeing you PCP every month just in case.

 

      

 

SherylN
on 7/7/07 11:23 pm - West Bloomfield, MI
Thanks for the advice.  I see my PCP on Tuesday and will discuss it all with him.
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