I was approved for Lapband in 2008 when I had BCBS PPO plan. Fast forward to 2014....in January I changed insurance to AvMed and due to not having success with the band I asked my doctor to submit a request for a band removal and revision surgery for the gastric sleeve. That was in February and honestly I didn't have any hopes of them approving it. In March I was advised that they approved both surgeries! The only thing I had to do was go to another nutritionist visit and of course get bloodwork. Surgery is scheduled for April 24th.

I also know someone who AvMed approved their band removal and revision to sleeve after they were a self pay for the band. I'm not a representative of AvMed nor have I had them long enough to make a decision on how I like them as a whole. I do know that I'm happy with the approval for revision. 

I brought in my ins requirements and listed them for the doctor. Made sure that I got the letter clearing and recommending me for wls. I went to a dietician once a month and we went over diet and excersize log,  but I could have just had the doctor put it down in the notes along with a copy of my diet (wrote everything down with dAiley calorie intake) and excersize candy made sure they also kept a copy in the records. My ins required 5 years of weight from a doc office, just gave the ins vitals one visit a year and it worked. 

I am currently in the process of trying to get information from my insurance company and this is not an easy task, dealing with them. I have Coventry One, Carelink Tier 1. The problem I am having is finding an approved provider. I go on their website and there are Bariatric Surgeons listed, but when I call they tell me the only one approved is a state away;. I just don't get it. Bariatric surgery isn't possible for me at all if this is true, as it is a 4 hour drive for me. Has anyone had any experiences with Coventry One, specifically the Carelink Tier 1? I'm thankful for coverage, but it won't help me if I have to travel that far. 

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(cross posting in hope of getting response)

Long time lurker on here and now finally on track for surgery! Had my first consult on February 27th with Dr Kolasch at Southeast bariatrics in Charlotte. I found out my insurance (Empire BCBC) DOES require the six month supervised diet. Initially this was extremely frustrating for me as i know it has been for others. I have only been in Charlotte for the last 7 months so my new PCP I don't have much history with, but she understands and knows about my pursuit of WLS. Whats confusing about it is that i am seeing a PCP for the monthly check ins ( they call it med management?) and am SO WORRIED that I'm not going to follow the requirements or miss something and get denied in 5 months when my bariatric office submits my paperwork to insurance Anyone else have to do a 6 month supervised diet and if so what exactly did you discuss or have recorded by your PCP at each appointment??? this last month that i went in they weighed me, took my BP, Doc came in for maybe 4 minutes, palpated my abdomen, listened to my heart, told me i had lost 3 pounds-good for me because my BP also came down and sent me on my way. As i left the room i was sure to ask "you'll record everything at my visits for my insurance right?" and she says yes of course. I'm afraid that I'm going to miss something or not have enough information. My insurance is already super vague about what exactly should be included in a 6 month supervised diet.  Every time i have called, they just refer me to documentation online. Any suggestions or personal experience with the 6 month supervised visits welcomed!  So far what i have completed on my WLS journey:

• Exercise Evaluation: Check
• Nutritional Evaluation: Check
• Psyche Eval: Scheduled
• Support meetings:Scheduled
• EGD: Scheduled
• Sleep Study: Scheduled
• 6 Month Supervised diet: on-going 1 month down, 5 to go.