Question:
What is insurance looking for when they tell you have to do a 6 month diet?
My insurance requires you to diet for 6 mon. Seems to me this could be a a no win sitution....if you don't lose they could say WLS would not work either or if you do lose then they could say there you go you can do it! Help — Kim L. (posted on June 9, 2003)
June 9, 2003
You don't say what insurance you have and your profile is not public so we
can't see. Different insurances can be looking for different things. Some
want to see if your disciplined enough to follow the dieting instructions
after surgery and some want to see that you've attempted diets and
lost/gained back weight. I have Aetna and my 6 month diet was Weight
Watchers. I lost only about 15 pounds in a 6 month period (I also went to
my PCP monthly so it was Dr. supervised) and was approved.
— Carolyn M.
June 9, 2003
They are looking for a way to not pay for your surgery in 2003! There is no
real reason to do this especially if you have been dieting for years like
most of us. I am sorry to say that you will probably have to do it if that
is their requirement but they have no requirements on how much you are
supoposed to lose and if you lose nothing it has no effect on whether they
cover you later or not. That is what makes the whole thing rediculous! I am
sorry you hae to deal with that but I wish you luck!
— Carol S.
June 10, 2003
I have been through all of this. I applied for the surgery when I was 17
years old, and I got denied numerous times. The insurance didn't ask me to
go on a six month diet, the office manager of my surgeon did. She deals
with insurance companies all day, and she said if I do this diet for six
months they are sure to approve me then. So I did as she said and went to
my primary care physician around the same time every month for check ups
for the diet. I started at 300#, and in the first 2 months I lost 10#'s,
but then I got tired of the diet, and then I started gaining weight back.
Don't think you have to be on a horrible strict diet just go as you are
able to. You don't have to lose 20#'s, just show an effort you are trying.
You don't even have to stick to a diet, eat sensibly, cause after surgery
thats all you need to know is be sensible about food. So through the whole
six months it was an up and down process, which it really didn't matter how
much weight I lost. Of course my doctor gave me diets and Xenical to try,
but I just stuck to my own. Really you just have to show an effort of
trying. When I finished with my PCP on the last month, I left straight from
there and went and dropped off the papers to my surgeons office, and they
filled that day with my insurance company. It hasn't even been 3 weeks, and
I got a call of approval from my surgeons office. I am now 18 yrs. old and
my surgery is schedualed for July 7, 2003. So don't lose hope. Through all
the ups, downs, and the emotions dealing with your insurance company have
hope. If you want this surgery so much, you should be willing to try
anything. I was and it has paid off. So keep hope and follow your surgeons
orders, and stay on the insurance company. Can you e-mail me back and tell
me what insurance you have?
Your Friend,
Danielle
— Saleen98
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