BCBS ppo

Hi can anyone tell me with this health plan do they require a 6 month supervised diet?

I am not 100% certain, but I believe it depends on what the subscriber's employer has negotiated as agreeing to cover. 3 different people could have BCBS and have 3 different coverage levels based on their employers. SORRY I couldn't help more, but you could always call and ask them what is required... GOOD LUCK! Dawn McG

Loriann, I have BCBS PPO - and they did not require the supervised diet. Actually, as insurance companies go, they were a pleasure. Quick approval and no hassles at all. Good Luck. Be Well, A.J.

Loriann~ I have Horizon BCBS NJ HMO, they didn't require a supervised diet, but did require a detailed weight loss history from my doctor and myself. As A.J. said, they were a pleasure to deal with. They made the entire process very easy, no questions, no denials. They are the best to work with, from what the surgeons office has told me. good luck. michelle brennan

Dawn is right, it depends on your coverage. I also have a BCBS PPO (Illinois, through UPS) and they were awful to work with! My policy began requiring the 6 os. supervised diet in September, 2003....my surgery was in June, 2003 and BCBS dragged their heels in paying my surgeon for over 1 year, saying I had not met their requirements for the diet. They finally did pay him, but it was a very stressful year for me in dealing with them. You can definitely call to find out the specifics of your policy coverage. julie

I called Horizon 4 X and I specifically asked them what was required and all they told me was the "Letter of Necessity"! I asked them about the "6 month medically supervisied diet" and they told me they didn't see it in my plan! I also confirmed this w/ my benefits administrator @ work. I got submitted on 9/28 and on 10/12 I got this email from my surgeon's assistant... "HORIZON CALLED THIS MORNING... THEY ARE REQUESTING 5 YEARS OF DOCUMENTATION SHOWING MY WEIGHT & VITAL SIGNS FROM MY PCP. THEY ARE ALSO REQUESTING A REVISION OF THE LETTER OF NECESSITY FROM MY PHYSICIAN TO INCLUDE THE LAST 6 MONTHS OF MEDICALLY SUPERVISED DIETS, INDICATING TYPES OF WEIGHT LOSS EFFORTS. Are you frickin' kidding me! I'm about to lose my mind! My letter of necessity states what types of weight loss programs I have done over the years. i.e. Weigh****chers, Jenny Craig etc.. I did NOT do any medically supervised diets!! It also states this in my letter from my Psych Consultation. I did get a phone call on Friday from my surgeon stating that they are looking into this! I know that BCBS Independence was requesting the 6 month supervised diet (as of August, 06') but I was told they've since backed off of this. Horizon PPO is a different plan than Independence was not requesting this either back then, so now don't know if this has just changed, but I should be "grandfathered" in due to I've already gone through all my pre-op steps for surgery! How recent has anyone else gotten approved or denied by Horizon PPO??