Arghhhh....6 Month Weight Management

[GiGi3 33]

I had my consultation last week. The coordinator got back to me and told me my insurance asked for 6 months of weight management.

Seriously? I am going to check it out for myself because when I called my insurance company I asked him about it and there was nothing in there that noted it. Maybe it shows up for pre-authorization. Anyway...I am depressed by it.

I have been on weight management since I was 14 years old. I am now 54. My doctor thought it was ridiculous for insurance companies to require it.

What prevents someone from making up documentation? Has anyone ever done that? Please feel free to send me a private message. What happens if I do lose weight and no longer fall into the bmi of 35-40 that my insurance requires?

What happens if I do have "weight management" and I don't lose weight?

I have to go see my Internist next week to request him to write me a Letter of Medical Necessity. I did see him four months ago, maybe we can consider that my weight management.

I am so frustrated by this. I was feeling giddy before the email, now I am just &^%$.

[Nate 292]

It's somewhat common. My insurance required me to go through 9 months of weight management appointments and support groups as well. I think some companies make you jump through hoops to prove your comitment. Thats the only thing I could think of.

[Barisaxylady 154]

Have you ever done Weight Watchers? My insurance accepted 6 months of continuous weigh ins from WW. Mine were almost a year old too. Good luck. Insurance companies are such a joke. Mine will cover weight loss surgery but not a nutritionist to avoid the surgery. shesh!

[traceyinflorida 499]

I know how frustrated and dissapointed you must feel right now. Once you make the decision to go ahead, you just want to DO IT! I went through the same thing. I can tell you a few good things about it though. The time flies by. I know six months seems like an eternity but in the grand scheme of things, it is pretty quick. Take the time to really get a handle on your issues with food, like emotional eating etc while you are going through this mandatory period. Also, take the time to start practicing some of the habits you wil need post op, like taking small bites and chewing really slowly. Also, get all your required appointments like the psycholgy visit, the PCP letter of medical necessity etc rolling for the sixth month so that when you have your last nutrition appointment, they can just go ahead and submit your paperwork. Look back on your prior supervised weight loss, because it can count as long as it is consecutive and not too far back. Like Barisaxilady said, Weight Watchers counts if you have documentation. Good luck!

[VerticalMorey 31]

I had my consultation last week. The coordinator got back to me and told me my insurance asked for 6 months of weight management.

Seriously? I am going to check it out for myself because when I called my insurance company I asked him about it and there was nothing in there that noted it. Maybe it shows up for pre-authorization. Anyway...I am depressed by it.

I have been on weight management since I was 14 years old. I am now 54. My doctor thought it was ridiculous for insurance companies to require it.

What prevents someone from making up documentation? Has anyone ever done that? Please feel free to send me a private message. What happens if I do lose weight and no longer fall into the bmi of 35-40 that my insurance requires?

What happens if I do have "weight management" and I don't lose weight?

I have to go see my Internist next week to request him to write me a Letter of Medical Necessity. I did see him four months ago' date=' maybe we can consider that my weight management.

I am so frustrated by this. I was feeling giddy before the email, now I am just &^%.[/quote']

I've been there I had to do a six month program also I started in jan and just had my sleeve done Monday. Time flys by especially if you schedule all your appointments for everything in advance. On the day of my consultation I scheduled every appointment I would possibley have and then just showed up it made it a lot easier...

I lost some weight but trust me it's not that bad insurance just wants to make sure you are trying and taking it seriously after all they are paying for it.

Good luck to you!

[GiGi3 33]

Thank you for your support and kind words.

Besides weight watchers, what other programs are there? Does online programs count?

I assume it can't be my own thing.

I have never done "group", organized weight programs. I have always done my own thing.

[VerticalMorey 31]

Thank you for your support and kind words.

Besides weight watchers' date=' what other programs are there? Does online programs count?

I assume it can't be my own thing.

I have never done "group", organized weight programs. I have always done my own thing.[/quote']

You don't have to do group weight loss programs you can do it on your own. The only thing is you will have to get previous year weights from your pcp to show your weight gain and loss over the years

[lakobe00 63]

Time will fly...I just went to the doctor once a month and the nutrionist once.

[Barisaxylady 154]

I think it has to be officially documented in some way.

[Raven21 121]

I have to wait 3 months. I'm using the time to get in the habits of exercising, even mildly, every day, trying to increase my Water intake, and maybe even lose some weight before my surgery.

[traceyinflorida 499]

Thank you for your support and kind words.

Besides weight watchers, what other programs are there? Does online programs count?

I assume it can't be my own thing.

I have never done "group", organized weight programs. I have always done my own thing.

In order for the insurance company to count it, your monthly participation and weight has to be documented. Unfortunately, online diets do not count...even weight watchers because you are not having your weight documented. Trust me, I tried! I belonged to and followed the Jillian Michaels diet online. It did not count. Other programs besides Weight Watchers would be Quick Weight Loss Centers or any other weight loss centers or medically supervised diets like Medifast where you were monitored and weighed either weekly or monthly.

[sr910 55]

My coordinator originally told me that I'd have to do 6 months of medically supervised dieting, per the insurance company. I called the insurance and there was absolutely no mention of "6 months." They did say that I had to have "actively participated in non-surgical methods of weight reduction" and that the doctor had to "fully evaluate" that, but nothing about 6 months.

I spoke with my coordinator the other day and mentioned that, and she said, "oh we'll just have you do the 3-month that also incorporates an exercise program." I still won't actually get sleeved until December (I haven't even had my first nutritionist appt yet), but at least it's not 6 months of dieting because the coordinator *assumed* my insurance had the 6-month requirement.

I have Anthem Blue Cross Select H M O in California -- maybe you can ask?

Good luck with everything.

[GiGi3 33]

Thank you again for all the information and answering my questions and concerns.

sr910- I just sent the coordinator an email. I know United Healthcare requires it for some plans and not for others. I mentioned to her that I called them twice in the last month and asked them, and both times it was not in the requirements. I asked her who she talked to. I told her someone at my work had it done last year and they did not require it. Maybe it will get her to take a closer look. Maybe, I hope she just assumed all plans were alike.

Sounds like a money maker to me making one do the Weight Management, one would think they get a kick back.

Anyways....I liked my Doctor and his Staff.

I appreciate the "time flies" that makes me feel better.

[VerticalMorey 31]

In order for the insurance company to count it, your monthly participation and weight has to be documented. Unfortunately, online diets do not count...even weight watchers because you are not having your weight documented. Trust me, I tried! I belonged to and followed the Jillian Michaels diet online. It did not count. Other programs besides Weight Watchers would be Quick Weight Loss Centers or any other weight loss centers or medically supervised diets like Medifast where you were monitored and weighed either weekly or monthly.

I have United Health Care and weight watchers and individual dieting did count for me. with weight watchers your progress is tracked online all i had to do was log onto my online account and show my progress. the purpose of the 6 month program is to track your progress and dcoument a medical advised diet. Through my insurance we have Bariatric Resources who handled everything along with my Dr's office. I would reconmend you call your insurance and see whats offered. I had to submitt 5 year weights and complete the 6 moth program. when i submitted to insurance on june 20th they called me 2 days later approving me and I was givin a surgery date

GOOD LUCK!

[VerticalMorey 31]

I actually found my weight management program to be very helpful preparing me for surgery. It was very informative and my dietition and nutritionist would put me on plans to prepare me for what was to come after surgery. Believe me i felt the same way, but i'd much rather me infomred educated and prepared verses just having the surgery and then having to learn what to do and not to do...

You will ultimately have to do whats best for you!