Question:
BCBS of Illinois HMO

BCBS HMO of IL has a requirement of providing proof of a five year medically supervised diet history. I have a referral from my PCP, and an appointment with Dr Kushner @ Northwestern Memorial next month. I can't provide a five year 'documented' history for the insurance. Does anyone know if it's a firm requirement or will my list of co-morbidities be enough to over ride the history?    — Angela T. (posted on August 26, 2003)

August 26, 2003
Angela... check your email :) I live in Rockford and also have BC/BS HMO IL... I didn't have to show anything concerning past diets and the only co-morbid I have is osteoarthritis... I'm here if you want to talk :) Tracy
   — Metal Girl

August 26, 2003
Angela, I used to have BCBS HMO OF ILLINOIS Now I have Blue Advantage HMO Illinois, but I didn't need any diet history for insurance. I think that you should have your pcp submit to the insurance with a list of all your co morbities.
   — marian

August 27, 2003
Hi Angela! I can't help you too much, as I have BC/BS of Illinois PPO ... but I just wanted to tell you that I've had my surgery through Northwestern Memorial as well ... I have my first post-op visit with Dr. Kushner tomorrow. I remember, they did have me "chart" weight loss programs (doctor supervised or not) that I was on ... if you can at least do that ... approximate times you were on Weight Watchers, Jenny Craig, etc. and even things like Dexatrim or Metabolife, etc ... that's a start (they usually want to know about "doctor supervised" programs, but put 'em all in there to the best of your ability). I know insurance companies are getting a bit more strict, and actually, the surgeon's staff (my surgeon was Dr. Murayama, who is no longer at Northwestern) was responsible for writing the medical necessity letter ... don't know if that carried more weight or not, but it worked (BC/BS originally said MY COMPANY didn't want this surgery covered, but they turned around and covered it 100% after the medical necessity letter). SOOO ... good luck, I'm here if you'd like to talk (or meet with you)! Lap RNY 06/18/03 -45
   — Karyn B

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