Okay so, after weeks of waiting,  I  finally get a surgeon consultatation date.  I show up and to my dismay, upon going through my paperwork, I have a letter of recommendation of WLS from my PCP but not my approripiate referral.  So the front office desk, despite the detailed letter from my doctor along with all insurance verfication stuff, sleep study, lab work, etc.  they stonewall me----and they weren't very friendly.  Though I had to make another appointment, the insurance coordinator who knew I was upset proceeded with the insurance information stuff in detail.  I have United Healthcare and apart of my plan is the 6 month nutrition visits, which makes no sense at all.  I'm really pissed about having to wait this long when everything can be done within a couple of weeks.   When I expressed my dissapointment I was told in a rather condescending manner that the purpose for the visits is to help me learn how to adjust to my new eating habits.  She said "It doesn't make sense to have the surgery and not know how to change your eating habit's"....Strike 1---who considers any type of WLS without the recognition of the complete overhaul of nutrition!!!!!!!!
Strike 2----my mom who also meant with the same surgeon for WLS was simply given a slip of paper that was entilted diet plan.  The nutriontionist in cavalier fashion told her she could follow it if she wanted but not a requirement---she thanked her and told her she would see her next month.
WTH.......What is the purpose again of waiting 6 months again????  There's something in my policy about 2 diet programs for 3 months but no one seems to be able to give me info about that in my plan, because everyone keeps pushing the 6 months.......

I really want to get around this....Help!!! My consult is tomorrow.

 Call your insurance company yourself and talk to them.

The insurance company works for you.  The Doctors office works for you.

You tell them what is acceptable and what is not.  Take control of the situation the way you want to take control of your weight.  You are no ones victim here, you are at no ones mercy.  You may have some contractual obligations with the insurance, but its up to you to know what those are and manage them - not the surgeon.

 Call your insurance your self and talk with them yourself,  but 6 months seems to be the basic rule of thumb that I hear on these forums.     And just a side note why would you want to go through an office where they are snotty and mean,  I would look into another WL place .........  My office is super nice and everyone excedeingly friendly they bend over backwards to help out and find out info that I need, plus 60% of the workers have had surgery themselfs....    Just saying....   good luck 

When i was battling my insurance over one document to get me approved, I called and they showed me where to find my policy on bariatric surgery on my plan on their website. There I could read everything they have as well.

So I agree...call your insurance. Have them show you wher eyou can find your policy. My insurance at one time required 6 months of weight management but I have also heard of people who have been on Weigh****chers being able to take some of the time off.

Good luck!

I know the six months wait is frusterating. I had this requirement through my insurance also. I started this process by getting a referal from my PCP in August of 2011 and after my six months, plus all the additional required appointments including the psych eval, 3 required support group meetings, appointments with the bariatric center's personal trainer, 2 sleep studies and 3 additional appointments with the center's nutritionist, plus the additional time for the insurance to approve me once I had met all the requirements, I wasn't sleeved until June of 2012. I was just as angry as you at first. I had made the decision to make the change and I wanted it to happen NOW.

That being said, since having the surgery I can tell you that all the preparation was worth it. Furthermore, I don't think I could have successfully made the changes that I have had I not truly invested myself in the process. Making up your mind is the first step, but I think you would regret it in the long run if you were able to have the surgery tomorrow. You absolutely need the mental preparation.

If your health insurance is going to cover your surgery and they require a referral and 6 months of supervised dieting, then that's what you have to do.  If you show up at any doc office without a referral and your plan requires one, then the doctor will typically not see you.

Overall, it is our responsibility as patients and as the people who buy health insurance to call the insurance company and find out what every single rule is for the type of procedure we are having. 

After reading all of the posts here, my first step before seeing any doctor about WLS was to call my insurance company and find out exactly what I needed to do. 

PS -- I have know MANY people who go into WLS without a clue.  It's amazing, but true.

Personally, I'm glad my insurance has the 6 month supervised diet requirement. It has given me 5 months (so far) to make some adjustments in my life. I have been weaning myself off of certain foods, changing my habits (like drinking with my meals; eating protein first) and being more aware of what goes in my mouth.  I know this will make it that much easier for me when I do have my surgery.

It has given me time to learn all I can about how my life will be after; how to handle different situations, etc.  It has given me time to reach out to others (via OH and support groups) to find out about their experiences (good & bad).

Why are you ticked off? I thought you were going to say your ins. co. denied the surgery like unfortunately so many people have experienced. Be thankful that is not the case.

I had to go through 6 months of nutrition counseling as well. I think that's pretty standard unless you are self pay or traveling to Mexico. I also think it's a good idea. In fact in my state it's a requirement before any WLS. Although they will accept documented weight loss programs too, like Weigh****chers or Jenny Craig or something like that done for a certain amount of time within a specified amount of time. If you have done this, check with the ins. co., this may be an alternative option.

It sounds like the medical professionals are just following the procedures set by yours and many other insurance companies.

I know we all know we need change our eating habits, but those six months of actively doing it prior to WLS sure makes the drastic change a lot easier when we HAVE to change. Instead of being ticked off, take the time to practice all those healthy eating habits you'll have to adopt.

There are a lot of changes and information to absorb. Although you may be aware of these changes it's more than the average person may think about. The standards are set with everyone in mind.

WLS is not something people should just jump into!

Thanks guys for the insight.....you're right many people are denied or don\'t have the coverage flat out so I shouldn't be so angry....frustrated yes, but not angry......I should mention that initially I was told at least 15 times that my coverage did not include the 6 months....Its been really dissappointing to have been told otherwise


Thanks guys

I have United Healthcare and they didn't have that requirement for me.  I realize that policies within insurance companies vary, so your best bet is to call them yourself and ask them to point out on their website exactly what their requirements are for YOU. Print them out and bring them to the doctor's office.

 Also, anytime you talk to someone from your insurance company, take down their name and the time of day you called, and the phone number you called them on -- and write down what they tell you and repeat it back.  Why? Usually these calls are tape recorded.

So, if you get changing stories, you can call and ask to speak to a supervisor, tell her what you were told, and ask her for a transcript because you are tired of getting different stories - and you expect them to honor what you have been told, since that person is looking up your specific coverage.

Good luck!