BCBS IL Weigh****chers/6 mo diet

Hello everyone! I know there are a ton of posts out here regarding IL BCBS and their 6 month weightloss requirement, which I think I have probably read thru ALL of them... lol :) Here is my question.

I have been going to WW since January 2008, and started seeing my PCP monthly beginning in April 2008. So right now, I am 3 or 4 months into my 6 months (depending on how you count the 6 months), and that is starting when I started to see my PCP. Do you think there is a chance, they will count January thru April as my 6 month weightloss too? I am sure hoping, otherwise, I have another 3-4 months before surgery...and I am growing increasingly impatient like many others here.... 

Any thoughts/advice would be appreciated... Thanks!!!!

Amy

It really depends on who looks at your case.  BCBS of IL is a crapshoot.  You could have a case manager that looks over it and sees the whole six months, but if you get a person that goes by the book, they will deny you.  My theory is that you should go ahead and try it with the six months that you have and continue to see your PCP while you wait to see if you get the approval.  If they did deny you, you could appeal it with the info after you've completed the full 6 months of PCP monitored diet.

Hi Amy,

I have BCBSIL (POS),  they told me they wouldn't count  Dec-Feb W.W for me. So my 6months didn't start till Mar 3rd with the nutritionist and will go till Sept 4th. They said I have to be weighed every month (30 days) , If I miss one weigh in, the 6mos starts over.  buncha crapola!  But I am not going to miss one! Now the problem is getting everything else done, I'm getting the run around for the sleep study and the pulmonologist has a 3 month wait for appt.  I started this journey late Dec 2007 and by the way things are going looks like it'll be next Jan b4 I get the surgery, unless I lose too much in the meantime ( which probably is ok anyway).  Everyone says that  delays are common, but it is hard not to get discouraged.

Good luck to you, Paulette

I had BCBS IL for my surgery. I did WW for the whole 6 months.  I did not see my doctor once for my weightloss.  Regarding the 6 month diet, the only thing they requested was a nutritional consult, which I had for my diabetes.  So that portion I had no problems with.  My sugestion, give it a try.  What is the worst? You will just need to continue you supervised diet for 3 more months?

 

Thanks A TON!!!! That gives me lots of extra hope!! I am going to see my PCP right now to do my monthly weigh in anyway, and she is going to get the paperwork to my surgeon and we are planning to give it a try for approval. Like you said, what can it hurt?!? So that is what we are going to do. And I will continue to go to my PCP until I get an approval, just in case. I am SOOOO hopeful this will be approved. I would LOVE to have my surgery later this month or next month. Thanks again for your post. I will update when I know something more.

Amy