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6 Month Insurance Waiting Period

What is the best strategy during the 6 month insurance waiting period. I'm told that they want you to do a weight loss program for 6 months where you have to go in and be weighed. Is the best strategy to lose a little bit so it looks like you need help? What happens if you lose too much and they say you don't need surgery?

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  • Called Blue Shield today and the guy on the phone told me I didn't have to do the 6 months so I got all excited. Dr.'s office called and spoke to 2 different people and they said I did. I emailed th

  • WillowsKnot
    WillowsKnot

    I have BC/BS of Kansas City and I had to do 6 months of supervised visitations with a physician. It could not be a nut. They also know exactly how much I lost each month because I had to fill out fo

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I have BCBSIL and they still require it for me. :(

Wow!! My BCBS-IL policy no longer requires it... States vary as well as individual company's policy...

I needed my 6 months.... this is a very emotionally engaging journey... I needed preparation... Best wishes to you guys!!

Wow!! My BCBS-IL policy no longer requires it... States vary as well as individual company's policy...

I needed my 6 months.... this is a very emotionally engaging journey... I needed preparation... Best wishes to you guys!!

At first when I heard no more 6 month diet I was nervous it hit me. So I'm kinda glad they require it still. :)

It definitely has lots to do with the employer cause I have BCBS IL and don't have to do the 6 mth diet...every employer is different as well as the ins company...

Speeking on the topic about how much weight to lose before hand... My dietician said point blank to me that the insurance company doesn't even know your weight after your first weigh in. That they care nothing about how much weight you lost in between the 6 month period, just that you accomplish working with the dieticians for 6 months, etc. At the same time I am very heavy and couldn't lose so much in that time it would even matter anyway, I think she meant this for all people. She didn't know my specific insurance either, so I don't think it was about my coverage. She told me to work hard at learning to chew my food very well and pace myself through out the day. Not drink but 30 min before and after a meal, etc. She says you should focus on losing weight but more so on making the lifestyle changes you will need when you are recovering and starting anew after the surgery. I am very new at this since that was my first appt, so I only know as I was told and have no experience to go off of yet! Hope it helps though! I am curious if anyone else was told the same.

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So borntoshine - you're doing the 6 months through your dietician? what is everyone else doing?

I was told that the ins comp concentrates more on whether you gain weight during the 6 mths and whether you consistently go to all your appts...

HollyC- Yes, for my insurance there has to be seven recorded visits spaced out 1 month each with the dietician. The last visit is the pre-op. Also a psych eval and doctor referal have to happen. Now that you mention it I am really curious what other insurances require too! It seemed odd to me that it was all with the dietician. I thought actually I would have more with the surgeons office, or another physician.

Beautifulnewme2012- Love your name! That makes complete since what you were told too. At my appt she really was trying to stress the importance of learning new habits more than losing weight. She didn't say anything about gaining but I'm sure that can't be good! (Lord knows I don't need anymore!) But I know she told me specifically that the insurance won't even see how much I weigh after my first weigh in. That the first one was the only one that matters, and then they are only conerned with the other stuff. I hope I lose a lot of weight during this time period I am waiting, but if I could do that, I really wouldn't need the surgery LOL!

Hi everyone

I have question which it is necessary lose my weight in this months?

If i did not lose it does my insurance will refuse to do my surgery?

Thank you

HollyC- Yes' date=' for my insurance there has to be seven recorded visits spaced out 1 month each with the dietician. The last visit is the pre-op. Also a psych eval and doctor referal have to happen. Now that you mention it I am really curious what other insurances require too! It seemed odd to me that it was all with the dietician. I thought actually I would have more with the surgeons office, or another physician.

Beautifulnewme2012- Love your name! That makes complete since what you were told too. At my appt she really was trying to stress the importance of learning new habits more than losing weight. She didn't say anything about gaining but I'm sure that can't be good! (Lord knows I don't need anymore!) But I know she told me specifically that the insurance won't even see how much I weigh after my first weigh in. That the first one was the only one that matters, and then they are only conerned with the other stuff. I hope I lose a lot of weight during this time period I am waiting, but if I could do that, I really wouldn't need the surgery LOL![/quote']

Holly C--I am going through the same process now. I have two more visits with the dietician (April & May). My meetings are also more focussed on "changing your habits" than the actual weight loss. I also had additional clearances to complete, including the ones that you listed...

Little bits

Called Blue Shield today and the guy on the phone told me I didn't have to do the 6 months so I got all excited. Dr.'s office called and spoke to 2 different people and they said I did. I emailed the question and got back the answer that I do have to - why did that guy have to get my hopes up for nothing!!

Good news I passed the psych review with flying colors - said I'm a perfect candidate. Have my nutrionist appt on Tuesday - going to ask her if she can monitor my weight for 6 months - depending on how much she charges

Even if your insurance doesn't have a mandatory 6 month waiting period, your DR and Bariatric program might...Something to keep in mind. Lots of places have a program they expect everyone to follow, so even if the insurance doesn't require it, your program might...

I have BCBS NY and they no longer require the 6 months either.

I lost 50 pounds during my 6 month waiting period and I am glad I did! It did not affect my insurance in any way, as I aslo had other health issues that warrented the surgery (Pre-diabetes, High Blood Pressure etc). It gave me a jump on post weight loss and trained my body better in new eating habits and exersice habits. It also made surgery so much easier and made any surgery risks go down with ech pound lost. My surgeon said my liver was easier to move out of the way with the weight loss.

My body was better prepared for recovery as well! My recovery time was cut in half because of the weight loss.

I have BC/BS of Kansas City and I had to do 6 months of supervised visitations with a physician. It could not be a nut. They also know exactly how much I lost each month because I had to fill out forms every month I went to see him and it included a starting and ending weight and BMI. The form also had to include what I was doing every month to improve. So I had to increase my exercise, or cut back on something new, etc. Those forms got sent to the insurance company along with the psych eval, the nut consult and a letter from the surgeon to get my final approval for my surgery.

I did have a fear of losing too much (I know it seems counterproductive) because I know of several people who were denied their surgery due to this very reason. I am not diabetic, my blood pressure is only borderline and I have never needed meds for it. I have knee pain and back pain, but due to the lack of some of the other "standard" weight related issues.... I was worried they would deny me the surgery if I lost too much saying I could "do it on my own".

So, each month I would lose about two to three pounds. Enough to show progress, but not enough to not need the surgery. My real weight loss has been since I got my final approval!! LOL I am no longer worried, so now I have lost a total of like 34 pounds. I also know though from experience that I won't keep it off without this surgery. I need this tool. I need this restriction, but I also know that with this tool, I can be successful.

I am relatively new as well to this whole thing. My insurance requires a 6 month program they call the "I Can Change" program, where i basically have to talk to a life coach once a month for 6 months. At the end they will issue me a completion letter and the hopsital im doing the program through will need to submit with the package. As part of the program through the hospital i have to see the dietician 3 times. I havent lost any weight yet but i also havent gained anything since i started watching the way that i eat. Im glad but also annoyed at the 6 month program becuase I have to wait until end of July/beginning of August for a surgery date. I do have to lose 15 to 18lbs through before they will do the surgery so i do need to get my butt in gear!!

As stated by other posters the time has gone by fast and its basically already April and im 3 months in!

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