Question:
Insurance asking for 3 month doctor supervised diet.
We are afarid that if we lose weight in that 3 month period,our insurance will not pay for our surgery. We were wondering if that has happened to anyone. Our insurance company is The Mail Handlers Benefit Plan. — waltman (posted on August 31, 2006)
August 31, 2006
Hi, I know that every health insurance would like to see that you tried
every possible effort before desiding that the surgery is the right answer.
I had to provide as much information as possible on all diets I did
including physical activities. My weight was up and down, down while on
weight watchers ones i stoped weight watchers my weight went up again etc.
Don't be affraid it's the standard procedure. I hope everything will work
out for you, best of luck.
— olga8
August 31, 2006
Be thankful that it is only a 3 month diet ... I've read some people have
to do 6, 12, or even 18 months of supervised diets. It is the norm now ...
— peacefuldaizy
August 31, 2006
I, personally, have not heard of anyone being denied for losing weight
while on the sup. diet. For most of us having WLS, we can LOSE weight, we
just can't keep it off! lol. And losing weight is actually to your
advantage - the less weight going into surgery is better for your health
and it's less weight you have to lose post-op! Your insurance just wants
to make sure that you're comitted to a diet plan and show compliance - so I
don't think it really matters if you lose weight or not. If you're
worried, speak with your surgeon. Also, talk to your insurance co. and get
a copy of their benefits so you know exactly what you need to do to get
approved so there are no surprises! Best of luck!
— platypus
August 31, 2006
most insurance companies in pa. such as highmark/blues require 6 months as
do gateway, medplus/unison
medicare does not require pre-authorization as long as the procedure is
deemed medically necc.
most insurance companies are very specific that you follow a 6 months
supervised diet by your pcp. hope this information helps a bit...3 months
is really good..
— simplify67
September 1, 2006
I lost weight in my 6 month diet required for my insurance and ended up
being under their BMI requirement for surgery, but was still approved. Be
sure to ask your surgeon and ins. co about this though, I asked about 10
times before I let go and started following the diet just to be sure. Good
luck!
— [Deactivated Member]
September 4, 2006
If you are able to lose weight on a diet, then it is better than having
gastric surgery, in which your "plumbing" is changed! Gastric
bypass is for those who CANNOT lose weight another way. That is why they
make you do it, to see if you can lose without the surgery. The surgery is
difficult, so you are better off losing the regular way if you can. If you
can't, then you will know you gave it your best shot, and feel comfortable
witht he surgery.
— Novashannon
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