insurance question

hi, i'm new and i have a question. i'm looking into wls after my best friend had it done. i have blue cross, blue shield-nc and i read that they need at least five years worth of documents of being overweight, right? well, i never went to the doctors on a regular basis. i never went five years in a row. do the previous five years have to be in a row or can it like skip around? i know, myself, that i've been overweight since at least my freshman year in high school(2001, terrible cheerleading tryouts haha) but since then and now, i can only recall going to a doctor in 2008 and earlier this year. will i have to wait 4 more years? cause if so, that's gonna SUCK lol

thanks!

I called my insurance company and asked about there policy on WLS.   They gave me the information on what there criteria was and what it would cost me.  

The answer to your question depends on what sort of policy your provider (work? school? whoever arranged the policy) pays for. You need to call the number on the back of your insurance card and ask for specifics on YOUR plan. I would also ask that they either copy and send you the relevant information from your plan book, or refer you to the specific pages in that book so that you can really check out the information you need.

In my case, I have BC/BS, and (although my doctor has 20 years of failed weight loss attempts), my policy said that if my BMI and comorbidities reached a certain level, I was good to go immediately. It's really variable, and depends entirely on how YOUR policy was written.

Hey, As mentioned before you should call your insurance company but not only ask them about your policy also ask them to send you a copy of the policy. This way you can reference the precise sections and such from the document that you might not understand( this assures everyone is on the same page .   

I would also repost your question to the Insurance, Cash Pay and Finance Forum  

Oops, I didn't see that forum, but thanks!


And thanks everyone else for your answers!

In addition to what everyone else said about checking with your insurance company, when you do, you should ask them about your situation.

Ask - If not 5 consecutive years, is it acceptable to have some documentation that proves you were overweight as far back as 10 years ago. 

I had the same requirement with Aetna for my approval, and although I hardly ever go to my regular doctor, I do get an annual exam from my OB/GYN so I was able to get a 5 year weight history from her.  

I just had surgery and have BCBS-NC.  First it depends on the type of insurance you have.  I have Corporate, but if you State or Medicaid (I think) there are different parameters.  I only had to have go back 3yrs.  If you have the State program I know they require a 6 month physician directed weight loss period.  If you have corporate, they do not require this.  You can access their guidelines online (all 12 pages of them).  I had no problem getting approved once I jumped through all the hoops.  I suspect most WLS Offices in NC would be familiar with what you need to do.