found out bcbs michigan

Thread Starter  

well after 2 weeks i found out i have to go to m,y dr for 6 months sept,and have her put me on a diet and weigh in each month,then i guess nxt step is get bk with the LAP-BAND^® people and see what i need to do to send to the insurance company.i guess i should wait to go to the LAP-BAND^® dr till then?i mean after the 6 months,or shpuld i be doing more stuff in between any help be nice.thanks

Oh no! I am so sorry. I have BCBS Michigan and was told I would be approved right away, but I don't have my appt. until April 3. What is your BMI? Mine is 48.

I wish you much luck! The Michigan board here is great, too! Maybe someone there can help.

The 6 month medically supervised diet is common. While you're doing it, educate yourself on the banding procedure and practice not drinking anything with your meals.

__________________
Elisabeth :)

Highest Wt 440 lbs, Banded on 3/30/06 (351 lbs)
Dr. Geiss, NY
5/25/06 1st (1.5 cc in an 11 cm VG Inamed Band)
6/21/06 2nd, (2.5 cc) 7/20/06 3rd, (2.0 cc)
9/07/06 4th, (0.3 cc) 10/18/06 5th, (0.3 cc)
12/7/06 6th, (0.5 cc) 1/4/07 7th, (1 cc)
2/13/07 8th (0.2 cc) 3/26/07 9th (0.3 cc)
5/7/07 10th (0.25 cc - total of 8.85 cc)

Thread Starter  

hi mine that to.i have to go on a diet for 6 months,then turn in everything to see if theyll approve which im sure they will,cant wait till sept,have to weigh in each month have dr record it plus shell turn in my records,im sure hoping,i know the LAP-BAND^® people said i do have benifits,i have bc mich,but live louisana,use to live mich tho.thanks janet

Thread Starter  

thanks elizabeth so how much you lose all togther?

I have BCBS Minnesota, and they also require a 6 month supervised diet. I went ahead and schedule visits with a nutritionist, even before seeing the LAP-BAND^® folks, just to get the process started. In the end, the insurance was willing to accept my 7 months of Jenny Craig that I had done the year before. If you have any diet program that you did consistently for 6 months in the last 2 years, you should get the documentation from them and give it to the insurance folks at the surgeon's office.

I have BCBS of Alabama, and after the 6 months, I was denied. I hope it is better for you in Michigan! Good luck!!!

Thread Starter  

hi,i went jenny craig bk in 89.lost 75 pds.was just to much money each month.how long after u turned in everything were you approved? thanks fpr help janet

Thread Starter  

did you apeaL it? what was reason denied,i know they said i had benifits

I was approved within a week of submitting everything. Took me from November 1st to Dec 20th to do all the pre-op visits (exculding the nutritionist stuff).
But, I do know that the JC had to be within the last 2 years. Nothing before that would count.
Good luck with the process.

I have BCBS of Michigan and my doc went back over her records and showed that I had dieted and lost weight but had been unable to maintain. I didnt have to wait another 6 months. She had even prescribed Meridia in the prior year. I stopped taking it because it raised my BP. The main thing they want is to make sure you have tried this on your own before resorting to surgery. Maybe if your doc has some documentation of your weights, that you have talked about diets, or prescribed you some weight loss meds, you may be able to get around the 6 months because you have already done that and more.

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Some things have to be believed to be seen.

Thread Starter  

hi,yeah i think cuz i hadnt been on a dr from dr is why,i think ill be approved because they sAID I HAVE BENIFITS BUT I HAD TO DO 6 MOnth,diet from dri live in louisana tho and have bcbs michigan ,general motors,im bmi is 48,so ill do the 6 and hopefully then be approved i wouldnt think theyd make me do all that just to turn me down,thanks

Hi Sheba08, I also live in Louisiana and I have BCBS of Minnesota. I am currently in the 6 month program. It seems like it is going to take forever for the 6 months to pass. I started curves, met with my nutrionist, waiting on my phsy. evulation, etc. I think the 6 month wait is what BCBS requires.

__________________
Robint

I know it seems like so long and such hard work. But don't give up, the insurance company would love that. It will definitely be worth it!

You can be one of 2 places 6 months from now. Banded, or not banded - the same weight with that 6 month diet still ahead of you.

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I would check in with your band doc before your six months are up. I started all my pre-op testing and consultations in about the 4th month, so I was ready for surgery right at the end of the six month. Hope that made sense!

__________________
Jammin' January '07 Bandster
Dr. Zoe Deol, Troy, MI: 1/22/07
Dr. Kevin Krause, Royal Oak, MI for aftercare.
Band baby: 9/12/08
Refill to 1.5ccs 11/08.
275/242/140