Question:
my insurance says 6 months of dieting, but it doesn't say consecutive
My insurance is BS/BC of Illinois. It says I would need 6 month supervise diet. But it doesn't say consecutive. The hospital where I'm going says it doesn't have to be consecutive, anyone know for sure? — pugsley101 (posted on May 24, 2008)
May 24, 2008
I don't have BS/BC, I have Pacificare but my medical group does require it
be 6 consecutive months through their program.
— caprisunn22
May 24, 2008
I also have BC/BS of Illinois, and they HAD TO BE CONSECUTIVE. I have
found that often, because the Hospitals deal with so many different
insurances, they don't always know what is required. I was given incorrect
information several times, from my Primary Drs. office as well as the
hospital. I finally found the one person, who dealt strictly with the
insurance companies and had the right answers. Be very careful. I was
told that if I missed a month I would have to start over. I wish you the
best on your journey.
— Jrsmomi
May 24, 2008
Like Vicki, I was also told it had to six months consecutive. Actually, the
bariatric center I'm using said 12 months. I did more checking and found it
was definitely six months BCBS IL HMO is what I have. I was also told that
if I missed even one weigh in, I would have to start the six months all
over again. Good luck! I also found one person in my utilization management
group who knew how to get things done. Once that happened, things started
to click. I have just finished with all the testing. Have a meeting Tues
with the fitness 'guru' and then everything goes to the surgeon to be
submitted to the insurance for final approval.
— norakeno
May 25, 2008
I have BC/BS TX and yes, the six months did have to be consecutive. But by
the time you finish all of your testing and what not, those six months
would have flown by. Don't worry...you'll get it done.
— Caliqt03
May 25, 2008
Yeah, don't go by the hospital. If you have a PCP make monthly appts with
them to weigh in and chart your progress. You've made the decision to have
the surgery so don't leave anything to chance. Start weaning yourself off
sodas, breads, sweets -- no drinking any liquids with foods -- because
after the surgery for about a year I'd not drink with my food. It was not
liquids 30 min before, during, or after the meal-- that's hard. And when
and where possible -- start walking -- if you haven't already. The more
you do physically within the next 6 months the easier the adjustments will
be fore you.
My insurance company said at least 6 months as well, however, if you missed
weigh-in with your primary care one month it wasn't held against me. So
just don't miss 2-3 months in a row and you'll have to start all over.
— the7thdean
May 25, 2008
My insurance requires the 6 month and IT HAS TO BE CONSECUTIVE, I know alot
of people that have had this surgery and they where required the 6 month
consecutive MD supervised diet.
My Dr' messed up my 6 month documented diet by going on vacation for a
month and I needed to re-start the whole process, just be on the safe side
and make it there monthly so they can document your weight and your major
complains, and health issues. be sure they document everything no matter
how minimal it may seem...and you'll be fine
— Jan D.
May 26, 2008
It is 6 months consecutive. Think about it. You diet one month then stop
the next month you dont then the next month you do. It can take you yerars
to get approved if it wasnt consecutive
— Joanc
May 27, 2008
Hi..I also have BC/BS of IL...At first when I started this process it was
12 months of consecutive months, then thank GOD changed to 6 months. I
followed all the rules and hoops and I was accepted for the surgery after
48 hours...Go for the 6 months, it is worth it. Don't play around and
think you can get around it, you will need to start over. In fact I went
to my surgeon AND my primary doctor each month for 6 months consecutive.
SO WORTH THE TIME!!
— usfour
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