How much weight history did your insurance company require ?

IceCreamDivorce
on 11/17/16 12:55 pm

Hi everyone,

I'm currently 2 weeks away from my 5th month of dietician visits and hopefully have my 6th and final visit

In January before my files are submitted for approval from my insurance company.  I'm pre diabetic and have had PCOS for years.  Weightloss has been a tug of war over the years . I'm concerned about the weight history requirement  My  surgeon's administrator says the standard is 5yrs that I have to show that I have had a BMI over  40 .  The problem is, that I probably haven't. I've spent the last 5 years starving myself, doing crazy extreme diets and eating fads where I had lost weight, but was never able to maintain it.  So I have been 220lbs and 1 time as low as 205lbs but was a 500 calorie/day diet. Each time gaining the weight back and more.  I'm at an all time high now and I'm finally sick of living for my bathroom scale.  I've checked my insurance company's website for bariatric surgery requirements but it says nothing about a weight history requirement.  I've even called their customer service twice and asked if there was a different list besides the one online with requirements and was told "no".  My surgeon's admin keeps insisting there is and that I need to have it by my 6th visit. I'm not sure what to do because now I'm starting to lose hope that I can get surgery.

What requirements did your insurance company have regarding weight history?  Also I have BCBS of Florida. Also keep in mind that All BCBS do not have the same requirements.

Kathy S.
on 11/17/16 1:36 pm - InTheBurbs, XX
RNY on 08/29/04 with

Mine was back in the Olden days....  My insurance asked for a list of at least 6 diet's I tried.  I ended up giving them a list of over 25 including all my diet books and membership for WW x6 and more.

Most insurances today ask for proof of at least 6 months supervised diet but not all.  Good luck to you and keep us posted on how things are going.

HW:330 - GW:150 - MW:118-125

RW:190 - CW:130

sunshinespring
on 11/17/16 1:43 pm - Bay Area, CA

Back in 2007 My insurance require a list of all the past diets beginning and ending, 6 months of supervised diet by a nutritionist and 2 counseling sessions, once you meet all the requirements the approval moved really quick, in like 7 months I had the surgery,

IceCreamDivorce
on 11/17/16 2:01 pm

Thanks for the replies Ladies . i've given a list of diets, I've had the medical tests done (upper GI, EKG , etc), I've submitted the letter of necessity from my primary care physician, I'm in 4.5 months of my supervised diet with my dietician and i'll be having my psychiatric evaluation in 2.5 weeks. 

I don't think i can come up with a 5 yr weight history 

AK_Gipson
on 11/17/16 2:24 pm
VSG on 04/14/14

Mine was about 5 years

           HW:292 / SW:258 / CW 173.9

      
  

Sparklekitty, Science-Loving Derby Hag
on 11/17/16 4:20 pm
RNY on 08/05/19

I'm with BCBS Arizona, and they required a 5 year history of BMI 35 - 40 w/ comorbidity, or 40+. I had to have a doctor's note (from ANY practitioner, I think my gyno note sufficed for one year) with a weight. Funny thing was, I was between 35 - 40 for several years but didn't get an apnea diagnosis until I was heavier, but that still counted.

Sparklekitty / Julie / Nerdy Little Secret (#42)
Roller derby - cycling - triathlon
VSG 2013, RNY conversion 2019 due to GERD. Trendweight here!

IceCreamDivorce
on 11/17/16 4:34 pm

Do you know if this is still the case for them? It could be my surgeon's admin person may be relying on outdated information. At least i hope so. 

Beam me up Scottie
on 11/17/16 7:09 pm
None. Just the weight I was when I had surgery.
White Dove
on 11/17/16 8:57 pm - Warren, OH

My list was four pages long.  It contained every diet and the starting and ending weight for that diet.  It was an interesting exercise to go through.  My surgeon required it, not the insurance company.

Real life begins where your comfort zone ends

Liz WantsHealthForAll
on 11/18/16 3:36 am - Cape Cod, MA
VSG on 03/28/16

I had to have 6 months of visits with a physician. Nothing prior.

Liz 5'3" HW: 219 SW: 185 GW: 125 LW: 113 Desired maintenance range: 120-123 CW: 120 (after losing 20 lb. regain)!

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