I am a Newbie- Starting the Process!!

Hi all,

So I have officially started the dr. visits and the requirements prior to insurance approval.  I am excited!!  I was just wondering how long after your initial consult with your surgeons were you scheduled for surgery?

Hello. I am a newbie as we'll however, I have already finished all my pre-op insurance requirements. I started last year in January but was denied and all my appeals were also denied because they required 2 years of a bmi of 35 or more and I only had 1 year. This year I started in February and was approved May 12. My insurance required a 3 month supervised diet with a nutritionist. I couldn't lose much because then I wouldn't qualify for the surgery but also was not allowed to gain ANY weight at all during that time or they would deny me for non compliance. Do you know what your insurance requires of you?

Hi R-lo, my insurance requires 3 months supervised diet with a doctor, a psychologist consult, pulmonologist consult, and a nutritionist consult.   Even if the insurance had asked for two years, my doctor (primary care) has a medical record of over four years where I have struggled with weight and at various points in my medical history have been prescribed prescription weight loss pills....nothing worked, now that I recently was diagnosed as prediabetic, have sleep apnea, and infertility due to weight, I was finally allowed the option of weight loss surgery.

What insurance do you have? I know some are more strict than others! My surgeon's office went over my insurance requirements with me at my initial consult, they are great and very thorough.

I have Aetna POS. They are pretty strict or I least I think so. Last year they denied me for being a couple of tenths of a point off of bmi. For me that would have been 1 pound. Even with my 5 comorbidities and being on medication for all of them, they wouldn't budge because of that 1 pound.

 It should go fast for you from here though. Before you know it they will be sending your case to insurance and I'm not sure about every state but here in Texas, insurance has 10 days to respond. If you are denied and appeal they have 45 days to respond. I wish you all the luck with your weight loss and journey.

From the consultation, it took 3 months to jump through all of the hoops, then 10 days to get approved by insurance once we submitted everything, then 6 more weeks to have my surgery.

There is a required amount of weight that is needed before surgery is scheduled. At least thats the path they are taking with me.