Question:
Has anyone been approved by BC PPO 1500 w/BMI >40 but no Dr. supervised diet?

I have a BMI ranging from 40.6-41 (depending on the day, etc.), but I have not had any Dr. supervised diets. When I called Blue Cross they were of little help, just said I needed the recommendation of my surgeon (maybe I got someone new?) and a high BMI. Any experiences with Blue Cross requirements in CA and have there been any exceptions?    — JLISOM (posted on March 29, 2006)

March 29, 2006
I do not have BC of California but I have BC of NC. They did not require a physicians supervised diet. I had to have 5 yrs of documented weights(did not have to be for diet records, I had some from when I was pregnant , some when I had a hernia repair etc) current thyroid test, current physical, a letter from my PCP and a BMI of over 40. But, you rally should check with who ever is in the insurance dept. of the surgeons office where you plan to go! They are usually very informative and can give you a list of what you will need! Good Luck!
   — jbailey

March 29, 2006
Good Morning! i am in CA and have the BLUECROSS PPO. I was approved on the first go 'round after seeing the nutritionist (Documented all diet history for over 10 years: WWatchers, Herbalife, Atkins, Slimfast, ^ week body make over, etc... - I did no dr. supervised diets) , Pyschiatrist and full med. exam. I had a BMI over 43, bad knees, family history of Obesity, diabetes, etc. GOOD LUCK! Hope all goes well with you. Best choice I have ever made. Hit the 100 pound mark today! Teri
   — TeriC

March 29, 2006
HI THERE! OHHHH, THE INS COMPANIES ARE PAINS. I WAS ON REGULATED DIETS BUT THEY SAID I WAS NOT ON ENOUGH OF THEM. ACTUALLY THEY SAID I WAS NOT REALLY ON ANY. WELL DARN, GIVE ME BACK MY MONEY FOR WW AND THE DOCTOR. THE INS PEOPLE CAN COME UP WITH DOOZIE REASONS FOR REJECTION. AT THE TIME MY BMI WAS 72. REALLY. SO I HAVE TO DO IT MYSELF. A BUMMER. DIABETES SLOWS DOWN METABOLICS AS DOES BEING OVER 30. YES, INS COMPANIES ARE DILLIES. GOOD LUCK, CAROL, BINK
   — BINK13

March 29, 2006
I to have Bc/Bs of Ca. My understanding was you had to have a BMI of 40 or higher with no co-morbidities or 35-40 with co-morbidities. I believe they do require documentation of diets. I just put down what diets I had been on and for howlong and how much I lost. and re-gained. Call and check with the ins. co
   — drunyan

March 29, 2006
Hi I have BC/BS hmo and I was approved an had a date in less than a month, I had already had completed my seminars all I needed to do was see a nutritionist and get a phych eval and it was done. I worked specifically with my surgeon's office ( Dr. Coirin... who is WONDERFUL!) I did not have to get approval from my Primary. They did ask me the diets I was on previosly and the outcomes, however they were not supervised. God Bless
   — britiiiz1

March 29, 2006
P.S> I was at a 40 BMI w/ no co morbididties, my surgery was 10-06-05, i have lost 70 lbs so far......
   — britiiiz1

March 29, 2006
I have Blue Cross Premier PPO, I looked up my coverage on their website while I was researching WLS. I found out what they covered before finding a surgeon and moving forward. I didn't call them that way I wouldn't raise in flags. I have heard both sides about BC PPO on they are very easy and very hard to get approved. Try the website and good luck.
   — Karen R.