What Would You Do If You Were Me?

[Caribear 184]

Hi all,

I need some input here. The insurance company I am currently with requires nine months supervised diet before they will approve surgery. I am going to my third month appointment later this week. However, because our family has been blessed with a new job for my boyfriend, we will probably be losing this insurance in the near future (medicaid). He and his dad are taking over a local business, and they will probably not be able to offer us insurance any time soon. Plus with my pre-existing health conditions I am afraid that we will either be declined for a private family insurance plan, or it will be prohibitively expensive. This means that I will probably end up being self-pay.

So here is my question:

If it were you, would you just forget about the supervised diet and go right for the surgery ASAP, or would you continue for the remainder of the diet, or something in between? And why would you do this instead of the other options?

I'm sort of torn about it. On one hand, I want to just get it done and get on with it. But on the other hand, I feel like it might be smart for me to continue with at least some of the diet to give me time to prepare physically and emotionally. I need some other opinions to help me figure this out.

Thanks!

[NWgirl 574]

I would probably continue with the supervised dieting while you still have insurance, as well as getting any necessary tests done before your coverage ends. This way you can learn some good tips and also keep your out of pocket to a minimum.

[smmrsue 56]

It is my understanding that insurance companies can no longer deny you based on pre existing conditions. That, however has nothing to do with premiums. Regardless, a high premium will usually be less expensive than forking out lots of cash for the surgery. With that being said, if he is just your boyfriend why wouldn't you still get Medicaid? Unless I read the post wrong.

If you are able to get another insurance plan some require a supervised diet anyway so I would definitely stck to it until you see how things shake out. That way you are already done when you get approved, or if you self pay, the extra support did not hurt you.

[Caribear 184]

@stephy- thanks, I never even thought of that!

@sue- I should have clarified, my boyfriend and I live together with our young child. His income will probably put our household over the qualification limit.

[Cazzy 725]

I would probably continue with the supervised dieting while you still have insurance, as well as getting any necessary tests done before your coverage ends. This way you can learn some good tips and also keep your out of pocket to a minimum.

Excellent idea

Do you have a hernia ? i know its been suggested u could get that quickly done under insurance and then just pay on top for the banding at the same time

[B-52 7,113]

Supervised diet for me was a big waste of time. I've been on diets before, know all the rules, and still failed at every one of the. Even the 6 month supervised diet my Insurance had me complete...started out ok, then started to gain the weight back. Only reason I had to do the diet was becuae the Insurance co. wanted it on record that I have attempted a medically supervised weight loss program, signed off by a Doctor.

Big waste of time.

And Oh yea, almost forgot....my insurance did not pay for the weight loss program, so it cost me $180 dolloars a week, out of my pocket. That included the office visit, shakes and Protein Bars.< /p>

Every week for the first 3 months, then every 2 weeks for the 2nd 3 months....OUT OF POCKET....You do the math!!!

BIG WASTE OF TIME.....Just another hoop to jump through before I can get on with the real weight loss.

[flab u less 45]

L

[flab u less 45]

I have insurance with the same issue.I hav e decided to self pay.I applied for a loan and borrowed some and had some saved. I just can't wait 9 months or more if they choose to try to deny and I have to appeal. So I am self pay.. and i am on the ketosis diet day 3.

[honk 780]

First I believe the law about not denying due to preexisting conditions for

ADULTS does not go into affect until 2014. It became a law immediately for CHILDREN last year. I would check into whether your state has a High Risk Insurance plan that people with preexisting conditions can buy. NH has one but it does not cover weight loss surgery. I don't think your boyfriends income counts for you as you have no legal connection to him. So you may still qualify for Medicare. You son however may no longer qualify if the boyfriend is his father and now has an income. I agree with a previous poster and do all presurgery tests you can. My doctor required Pap Smear, Mammogram, etc.

[mocaba1987 7]

Go to mexico and get it done. Its cheaper than getting it done here in the states or in canada

[1shauna1 129]

Nine months seems a long time. However I would continue it until you know for sure what's happening. Are you sure you're going to be covered under your boyfriend's insurance (are you considered common-law?)? Just make sure you know what's going to happen before you stop the diet; you wouldn't want to be screwed after stopping the diet.