Six Month supervised diet- can I get around this?

Vanvooh
on 3/25/19 9:56 am

Hello all.

I have UHC and they require a six month supervised diet or weigh****chers or jenny craig, etc etc. The thing is, I have had this surgery approved and scheduled with UHC before and been on a million diets ( as we all have) my entire life. Most recently, I was on Contrave and seeing my doctor but not every month. I saw her three times in about 4 months. Anyway- just wondering if anyone has had an experience being able to sidestep this as it really is kind of ridiculous at this point. I'm a veteran of weight loss efforts and now I have uncontrolled diabetes. Just am frustrated with all these hoops.

Thoughts?

H.A.L.A B.
on 3/25/19 10:39 am

If your insurance require that - then IMO it may be close to impossible to get around that. But if the center and your surgeon require that , you can get the info you already have and see if they would allow you shorten the 6 months diet.

Hala. RNY 5/14/2008; Happy At Goal =HAG

"I can eat or do anything I want to - as long as I am willing to deal with the consequences"

"Failure is not falling down, It is not getting up once you fell... So pick yourself up, dust yourself off, and start all over again...."

jenorama
on 3/25/19 10:56 am - CA
RNY on 10/07/13

I have UHC as well and I probably could have gotten around the six month thing as I'd been in the HMR program for a couple of years before finally deciding to go the surgery route. Call them and ask what information they require to waive the six month wait.

I went ahead and did the six month meetings with the program's dietician because I figured it was more time to get used to the idea of the new way I would need to eat after surgically altering my body. I wonder if they'll be more insistent that you actually go through the six months of dietician visits since you had it approved and scheduled before but didn't go through with it. I found they were very nice and when I made the initial call, I was assigned a caseworker person that would call me periodically and make sure I still wanted to do it.

I know you're in the "I want to do it now" phase, but I bet you'll be surprised at how quickly six months goes by.

Jen

Sparklekitty, Science-Loving Derby Hag
on 3/25/19 2:14 pm
RNY on 08/05/19

In six years on OH, I've yet to see of anyone able to get around the insurance supervised-diet requirement. Most of us have been on all sorts of diets over the years, but we're still required to do this to prove (accurately or no) that we will be successful after surgery.

Sparklekitty / Julie / Nerdy Little Secret (#42)
Roller derby - cycling - triathlon
VSG 2013, RNY conversion 2019 due to GERD. Trendweight here!

Grim_Traveller
on 3/25/19 3:23 pm
RNY on 08/21/12

There will be a lot of other requirements as well. Often they include informational seminars, individual nutrition meetings, group nutrition meetings, clearance exam from PCP, cardiologist, pulmonologist, sleep study -- there can be a lot. All of that can take six months, depending on how backed up they might be.

Extra time can be a blessing.

6'3" tall, male. Maintaining a loss of 280 pounds.

Highest weight was 475. Consult weight 04/12 was 411. RNY on 08/21/12 at 359 lbs. Current weight 195.

M1 -24; M2 -21; M3 -19; M4 -21; M5 -13; M6 -21; M7 -10; M8 -16; M9 -10; M10 -8; M11 -6; M12 -5.

(deactivated member)
on 3/25/19 5:24 pm
VSG on 03/21/19
As this surgery is elective, I think going through this battery of tests and appointments is the only way to ensure that the surgery is indeed required. I knew I needed it and I'm sure you know fine that you need it. Try to be patient and just go through whatever they ask of you and your date will be here before you know it. When I received my referral I was told from referral to surgery could be 12-18 months in order to get in all the appointments and tests that they require. It ended up being 16 months for me. Good luck in your journey! 11-00-2017 PCP Referral 02-21-2018 Orientation Class 04-12-2018 Dietician 05-03-2018 Nurse 05-29-2018 Nutrition Class 08-28-2018 Psychological Assessment 10-29-2018 Sleep Study 11-20-2018 Social Worker 03-01-2019 Meet my Surgeon 03-21-2019 Surgery Date
Partlypollyanna
on 3/26/19 3:09 am
RNY on 02/14/18

I have UHC and they were willing to use a couple of my dr appts that took place before the official bariatric program intake toward the 6 months -- my pcp has notes that we addressed diet and exercise in the record of those sessions. Because of the surgeons program requirements, it was still around 4.5-6 months for me anyway.

I was well versed in every program and I still found focusing on the new program and the time to get my head right useful; not sure you really gain a benefit by working around the system. The UhC bariateic nurse they assigned as a caseworker was a nice feature and since you are paying for it, they're a good resource too!

HW: 306 SW: 282 CW:144.8 GW: 145 (reached 2/6/19), next goal - 132.9

Jen

Julia S.
on 3/26/19 9:22 am - Beaverton, OR
RNY on 02/12/18

I actually gained 15 lbs on the 6 month physician supervised diet. UHC only requires that you meet with a Dr or NP or dietician for 6 times. It ended up taking me over a year to get my surgery approved, and it was denied once because my surgeon was not Center of Excellence Certified. This is only a requirement for UHC, so make sure they are approved before you get too far down the road. The hang up for me was not the diet and they really don't have a requirement for an amount of weight to lose. I was so frustrated I ate my feelings and figured I'd eat all of the things I wouldn't be able to. I would not advise that, don't do a farewell tour of your favorite foods, and try to follow whatever plan they give you. Good luck! You can do this!

5'5" Age 62 HW 291 SW 275.8 CW 168.4

Mary Gee
on 3/26/19 4:44 pm - AZ
VSG on 05/14/14

I was seeing my PCP for other issues, but I was weighed in for every visit and my weight was always brought up. My PCP actually recommended I have surgery.

I drafted a letter stating I had been under his care and diet and weight was overseen by him. He signed and submitted letter to insurance company.

It worked for me.

       

 HW: 380 SW: 324 GW: 175  

 

 

 

 

 

 

 

White Dove
on 3/27/19 10:30 am

Go to Weigh****chers this week and then next week and then the first week of May, June, July and August. You will actually shorten it to just a few days over 4 months.

March and August will count as two months. So will get six visits in four months.

Real life begins where your comfort zone ends

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