Met with my PCP this morning about having surgery

Thanks so much for all the advice.  I now understand how "taxing on the nerves" it is to call and talk to a different person every time at the insurance company.  I'm going to send a message to my PCP and see if she can put me on a Diabetic Diet and monitor me for 6 months like Theresa suggested. Have a great weekend.

Hey Wendy. If you see an endocrinologist for your diabetes, they should have a nutrionist that you should be able to see, with in his office. This should be a covered expense. If they don't, I would talk with your diabetic dr or your PCP and have them put you on a Diabetic Diet, and then go to your PCP for 6 months, to discuss how you are doing with it and for weight checks. This should be enouch for your 6 month monitored diet. And during the 6 months, you can complete all the other requirements, continue researching, and arm yourself the best you can. That was all I had to do and honestly, I have one of the funniest insurances. It is federal government, lol. At least, at minimum, it is work checking into. I hope this helps!

Thanks Theresa, I am going to message my PCP and see if she will put me on a diabetic diet and monitor me for the next 6 months. I don't see this as being a problem, and I think she will agree..at least I hope she will.  I am so thankful for the advice I have received from everyone over the past few days.  Have a great weekend!

Hi there.  I am completely new to this message board, but think that I may have something to offer you in your journey.  I work for a bariatric surgeon and am responsible for getting patients approved for surgery.  As a prospective patient myself, of course I do not want anyone telling me what I have to do and why I have to wait, but I agree with the insurance companies 100%.  How often do you hear that? The insurance companies will invest in you every time as long as you follow their criteria...and as long as your particular employer has chosen to purchase the morbid obesity rider.  Always call your insurance plan before any consultation to verify if you have coverage for the surgery.  If you do not - you will not even be covered for your consult. Carefirst in particular wants the 6 months PHYSICIAN supervised weight loss program.  Any of the other national programs will not suffice.  (Tip for those who want to do online - don't.  You need to have documentation that you have presented yourself in person to a weight loss program.)  Go once to establish with your physician that you need for him/her to document that you will be starting a weight loss program.  He will need to advise you on what to eat, how to exercise and how to change your behavior.  He MUST document it.  A letter stating that you were on a diet will not get you an approval.   Carefirst also requires that you have a psychological evaluation.  Go in network unless you can afford to pay hundreds for an eval.  You should be evaluated on whether or not you understand the actual surgery, on your understanding of post-op behavior modification and your level of compliance.   Compliance is the name of the game.  If you want the surgery, you have to play by the insurance guidelines.  They really do make sense.  I see patients every day who are understandably anxious to proceed with surgery, but those who have this pre-operative requirement really do handle the transition better.  Honestly, go to your PCP.  Pay your copay once a month - it's the most economical way to handle it and you need to have your PCP on board for this anyway.  Hope this helps.

Lori.