:'( What now???

I went by my PCP to get all my medical records for my visits regarding my diabetes.  Whi*****luded Dr. Notes discussing weight and exercise etc.  But I do not go to the Dr. frequently so I have only a few visits in the past 1.5 years.  But I have been obese since I was in grade school.  I saw a nutritionist for the first time in I think middle school.  I have tried everything!  I am wondering if I should start collecting really old medical records to give them as well? Or if it just matters the past 12 months.

I faxed the records from my PCP to my bariatric center so we will see what they say next week.  Apparently all of this just changed so I don't think the bariatric center knows exactly what they are going to require.  I am just very upset that they figured this out AFTER they gave me surgery clearance.  I feel as though they should have been aware of this, and I feel as though BCBS also should have told me this when I called asking about my benefits.  

I had to have 9 months documented (in a row) before my insurance would approve.  I completed them with my PCP -- but boy it sucked.

At the worst, you have a least a couple months already documented with the bariatric clinic.  I was wondering if your PCP might be willing to sign off on it?

I hope you can find a way.  I know it sucks!

I ran into a very similar situation - initially I got my referral via insurance, which usually means you are ready to start the surgeon's requirements and have surgery buy my approval was a mistake that my insurance carrier made. I was so excited thinking I'd have surgyer by April of 2016, but found out through many phone calls that I had to have 6 diet classes, three  visits with a physical therapist and 2 behavioral health visits. This process should take 8ish months. It took me a year from the initial referral. I was super frustrated at first, but the more I learned, the more I was thankful for the delay. I was very iffy on surgery as of September of 2016, then in October had a TIA. I have all the risk factors for stroke, except for smoking, and a huge family history. The surgery is a way for me to address most of those risk factors so that helped cement my decision. I'm five days out from surgery and it's crazy, but good. I hope you get some clarity soon! I ended up finding that the referrals coordinator at my primary care doctor's office was my best resource to help clarify what I needed to do. 

I'm kind of waiting to see what happens with mine as well - I also have BCBS.  My surgeon told me close to the end of December that the policy was changing to require 12 months, however we weren't sure if it also applied to revisions since it's a bit of a different ball of wax with my band developing problems.  I started this process 9 months ago so if I have to wait 3 more months I'll deal...I won't be happy with it, but I'll deal with it and continue to work at it.  

I have to remind myself, often, that this is a slow and steady marathon to a healthier me, and hiccups happen, but I won't let them derail me.  I would definitely talk to the insurance coordinator, and also get as many documents as you can showing that you've been working at this long-term.  Don't give up! 

it says notification was given 10/16 to be effective at the end of the year. If your first consult was December 2016, the unfortunately it will apply to you. 

Your surgeons office should have seen this when they first checked your coverage. 

Looks like you will have to do 12 months.

I saw the date :(  and I talked to both my insurance company and my bariatric office AFTER that date and still neither told me of that requirement.  

Of course when you call insurance they give you the pre-recorded message that nothing said to you is guaranteed (or however they word it).  You would think if you are talking to your insurance company with questions then they would have to actually give you correct information! I wish I knew the date that was posted online.  I easily found it when looking for it this time, but I had did the same searches in November and they didn't show up on their website.

The wait is a challenge but use it to your advantage. Learn all you can about nutrition and exercise and mindful eating. Practice using the strategies that you will need to adhere to post op (like chewing and eating more slowly and getting in adequate protein and not drinking fluids with your meals). If you can build these habits pre op it will make your surgical recovery more successful. Losing any weight before the surgery will also make the surgery less risky. Good luck!

I agree I definitely have things to work on.  But unfortunately I can't just work on those and keep losing weight. My bmi was a 41 on my initial consult date.  Now it is a 39 after losing just over 12 pounds.  (even then I had to lose and regain some because I was worried about my bmi for insurance) I hate to continue this process for 10 more months of trying to loose but then not being able to truly be successful because then I will get denied as well.  I can lose weight but I can't maintain it.  Granted I haven't gotten down to 225 before dieting, but I haven't started as low as I was this time either.  I used to be starting closer to 280 and I could get down to 240.  This time I stared at 262 and I am down to just under 250.  :/  

I get that I am probably just going to have to play their game.  But it IS ridiculous.  I wish I could just focus on losing and getting healthier before surgery but if I am too successful then in the long run I don't feel like I can be successful on my own.

That's just what I went through. I could lose weight but just couldn't keep it off. Ultimately that history demonstrated to the insurance company my consistent efforts and they ended up approving the surgery. I don't know that I would have been as focused and committed if I hadn't done all the up front work. But...I feel your pain. The constant battle and inability to maintain weight loss takes a toll on your self-esteem. Hang in there and know you'll get lots of support here. You're headed in the right direction!!

Looks like they might have left a loophole for those who had already started the process.....

Good Luck, hope you don't have to wait 12 months.