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Does everyone have to jump through hoops to get approval from the insurance company.



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I have to complete six weight management visits with my doctor, complete a psychological evaluation, meet a nutritionist, have my gallbladder scanned and do lab work. Is this the normal procedures? My BMI is 48 I thought that alone would get me a quick approval but no I have had to wait and be patient and I am ready now for the surgery.

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No, but some insurance companies do want to see if the patient can remain consistent and attend each Dr.'s appointment. Or I sometimes when I get really sick of the 6MSWL I think they want to see people drop below the covered BMI.

For me, my insurance requires the 6MSWL, a psychological evaluation, and that I have a BMI of over 40 with no comorbidities or a BMI of 35 with two. It really isn't a lot, but it sure can take awhile. The plus side is my insurance covers 100% if I meet their requirements, and that is totally worth it to me.

Though, take this six months to really prepare for life after surgery, how to cope with the major changes in habits and lifestyle, and prepare your loved ones.

Good luck on your journey!

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Yup, you'll find most of us with insurance have to go through the same hoops. Instead of the gallbladder scan, I have to do an upper GI. And 6 months of a supervised diet with a nutritionist, labs, psych, etc. My insurance first had 3 months, then changed it to 6. Some plans don't have these long processes in place prior to being approved, but most do. I am in my last month in August....and it went pretty quick since I started in March. Don't get discouraged, something this big and life changing takes time to adjust to. I am actually glad now that I had to wait as I almost had the Band done. I have had time to research, reasearch, research and read and prepare myself to know what to expect. I do know some people on the boards who have had the surgery done within a couple of weeks of starting the process and they have had a really hard time adjusting as I think they weren't prepared enough and didn't have a chance to completely 'wrap their head's around it', if you know what I mean. I have read so many experiences and stories, and I know I will have my own experience, but I feel really comfortable and well-prepared for whatever the surgery outcome will be.

Believe it or not, it does go quickly. And you don't have to beat yourself up and lose weight on the 6 month plan...just don't GAIN weight or the insurance company will think you can't be compliant and you'll have to start over. Both my surgeon and my NUT (nutritionist) said the goal isn't to beat yourself up over another diet, but to try and practice the habits you will need after the surgery - eating smaller portions, more Protein, use smaller plates/utensils, chew more, etc. If you lost weight, great! But if you don't drop 40 lbs, they won't deny you.

Hang in there and good luck!!

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One thing I forgot to add which is probably the most important. Six months has given me a chance to try and recognize and stop my bad eating habits due to 'head hunger'. A lot of people have a really, really hard time with the loss of food and I have read so much about that sadness and remorse and frustration that I have tried to identify my own issues and think, "Now if I had already had the surgery, I wouldn't be able to go and gorge myself on this _______ (pizza, McDonalds, donughts, insert favorite vice comfort food here) and how would I deal with that?" I continue to say, "I'm not going to eat that because I won't be able to indulge like this after the surgery and I need to cope with that and figure out how to deal with that 'loss". Now, mind you, it doesn't always work, lol!! ;) But when I don't go after the food, I do feel a bit deprived and try to figure out how I'm going to deal with those feelings after the surgery, because they are very real.

Just saying, this six months can really help with the mental preparation,which honestly I think is more huge than the physical.....

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Thank you for all the advise. I have completed half of my requirements and should be done completely by the first week of October. So i am hoping to have my surgery in November. I have taken the time to read alot of blogs and watch alot of youtube videos to get an idea about what to expect. I am just so excited about changing my life and really begining to live and not just survive. You have been a great deal of help :D

One thing I forgot to add which is probably the most important. Six months has given me a chance to try and recognize and stop my bad eating habits due to 'head hunger'. A lot of people have a really, really hard time with the loss of food and I have read so much about that sadness and remorse and frustration that I have tried to identify my own issues and think, "Now if I had already had the surgery, I wouldn't be able to go and gorge myself on this _______ (pizza, McDonalds, donughts, insert favorite vice comfort food here) and how would I deal with that?" I continue to say, "I'm not going to eat that because I won't be able to indulge like this after the surgery and I need to cope with that and figure out how to deal with that 'loss". Now, mind you, it doesn't always work, lol!! ;) But when I don't go after the food, I do feel a bit deprived and try to figure out how I'm going to deal with those feelings after the surgery, because they are very real.

Just saying, this six months can really help with the mental preparation,which honestly I think is more huge than the physical.....

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It depends on your insurance company. I had to do the same, then when my employer changed carriers, I had to do it allover again. My BMI was 41, now its 28.

The thing is, like it says in the Nike ad - JUST DO IT.

Your persistence and patience will be greatly rewarded.

From the voice of experience.

Take care and be well.

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Waiting waiting waiting. No stress here! LOL! I have been fighting insurance companies since 2008. Long story short, insurance co in 08 was a Pain in the Ass! Switched in 09 to discover policy had rider in it-no bariatric surgery of any kind! Switched again in 10, got distracted because hubby became disabled in late 09 and had major surgery in July.

Anyway, finally! I had to only do 3 month supervised weight loss with primary dr, 1 nutritionist visit, and 1 psych eval.

I am CLIMBING the walls here waiting for the scheduler to call with the date! OMG, how much longer can it be? I've waited 2 weeks now just to get a freaking surgery date! I'm trying deep breathing. It's too hot to walk. Calgon take me away!!!!!!!!!

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
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    • KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
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    • bellaamey

      https://alluniqueguide.com/java-burn-coffee-reviews/
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