BCN Insurance? Help Me Please !!

Hello, I was hoping that individuals with Blue Care Network insurance could tell me what the most recent requirements are for getting approved for gastric bypass surgery.  I tried to get approved in 2004 and was denied.  I have since gained even more weight and I am very depressed and want to start the ball rolling again.  What do the mean by 6 or 12 month consecutive diet history?  Do you have to go to your PCP every month for that long, or do they expect you to join a gym, weigh****chers, see a nutritionist?  Thanks for any help you can give me, all is appreciated !!     Shari 

As far as I know, most insurance companies require at least a 6 month diet history.  This means going to your PCP once per month (and don't go over 30 days!!! or they make you start over), document your weight, BP, the type of diet you are on and what exercise program you will be following.  This must be signed by a MD.  (not a PA or Assistant) Your surgeon will tell you about the nutritionist and psych consult you will need.  Sometimes they have a specific one they want you to see. (mine did) Call the insurance company and see if WLS is a covered event (at all). Why were you denied in the first place?  Does you place of employment perhaps have an exclusion for WLS?   If it is a covered event, find a surgeon, go to the orientation and support group and they will have much more of the info specific to your plan. Good Luck!

Hello, thanks for your response.  It is much appreciated.  They denied me in 2004 because they said I didn't have 12 months consecutive diet history .... heck, I've been on diets, diet  pills, exercise regimens my whole adult life ... can't they pull that information up with my social security number?  I just read yesterday that BCN will waive the 6 mos required diet history if your bmi is over 50 and mine is around 49.6 --- It would be alot easier and worth it to me to just gain 5 lbs than it would be to wait another 6 months for approval.  I just went this morning to have my fasting sugar, cholesterol, B12,etc checked.  I know it sounds really sad, but I am hoping my sugar or cholesterol come back high and they want to prescribe medication so I have at least 1 co-morbidity because at this point, I don't have any.  I may have sleep apnea because I absolutely never feel rested after a nights sleep and I never sleep all night through ... EVER !! I just need to go and get checked.  Well, thanks again for your help, this board is awesome !!  Have a wonderful day, Shari