6 Freaking Months!??!

janiee · January 21, 2007

Same thing is happening with me. I started my journey in May 06.
Once I got all of my tests in, they called me within a couple of days

with a surgery date of 2-12-07. Then called a few days later to let

me know the Insurance wants the 6 months supervised diet. They

should have told me awhile back, so that I could have been done.

Oh well, i'm over it. Went to the Doc today to start the diet. they

will start it with my last visit at the beginning of Jan. I usually see

a nurse practioner, I hope the insurance has no problem with that. :phanvan

Patti

Good Gracious!!!!!!!!!!What a let down. To think you were going in for surgery on Feb 12 and then told you have to do the six months diet.

At least they are letting you start from the beginning of Jan. This is my worst fear, that after the 6 months, they will either say no, or make me go through other things that will take more time.

tismepatti · January 21, 2007

Yes, It was horrible. It would not have felt as bad if I did not

already have the date. I was walking on air when I got the date,

I told everyone. I think the diet surgeons office should have

known about this before hand.

CLAUDIAGDLMEX · January 21, 2007

sorry but it took me 6 years 4 diffrent doctors and the insurance denied my surgery so I had to go out of pocket .. you make look into . your health comes first .. sorry to tell you the insurance dont care .. that how life is unless we do something about it .

either you wait or you do something for your self ..

good luck

maryrose · January 21, 2007

The sad thing about the whole deal with these insurance company games is that "yes" we can lose weight and I've done it 10 times over, but keeping it off..that is the big problem and "that" is why we need this band. Why can't they understand that. My insurance will start requiring a 1 year supervised weight loss approach. OK..Say I take that year and lose 50/60 lbs....then what? Research shows only a very small number of people can keep this weight off. So eventually, I'm back to square one. Are they hoping I'll drop dead in the meantime???...

It's really a shame that we have to deal with this, especially with the cost of insurance. I am paying big bucks for this insurance.

JAB7955 · January 22, 2007

Have you called your insurance company to determine if the lap band is covered? If you attend a seminar they will have information available for almost all insurance company requirements. Once the requirements are complete you will then be able to submit the paperwork for medical review by your insurance company.

Its a lot easier to have all your ducks in a row before you submit it to the insurance company. Its very difficult to fight a denial.

Missy22 · January 22, 2007

I also had to wait 6 months for my approval. I am glad I had that time, use it to start eating healthy, getting into an excersise routine, writing down your goals and expectations and getting your mind set for this big change. It will go by so fast, I promise. It feels like just yesterday but I had my surgery almost 4 months ago and have lost 45 lbs, I also had had hypothyroidism for several years. I was however approved in one day which I hear is not common, the approval usually takes a while. I would suggest following all your appointments and instructions for faster approval. Good luck!!

GoddesPotential · January 24, 2007

I saw my first Dr. appt on the 17th. That's when they handed me my 6 page thick "to-Do's" before I can think of going to the SURGEON! I too was/am appalled.. trying to think of anything to help speed this process up, however IT is the insurance Co. The alternative is getting financed, and well, my credit is to iffy for that! Yesterday I completed my sleep Apnea requirement, and today I went and had my Metabolic panel done (that's a two-hour process in itself). How very sad that is that I'm hoping those tests will show borderline Diabitis or that I stop breathing in the middle of the night!!! I should be ashamed, but then again I'm desperate!!!

Keep talking to me maybe those 6 months will go by a little faster for both of us!!!:huggie:

Goddes' (potential)

faithmd · February 4, 2007

My insurance is 1 full year, with monthly weigh-ins. You miss a single one, and you start from the beginning...

I only hope that my Dr. has been documenting what is needed in my chart (my discussions of weight loss attempts, exercise, etc...) or else I'll be back at square one again!

mrspruett · February 4, 2007

I have Anthem/ BCBS and in my insurance guidelines I am required to have a BMI of 40 or above (I am at 42), a psych consult (scheduled for tomorrow 2/5/07), and a nutritionist consult (not scheduled yet). No mention of a supervised diet program in their requirements. I have sleep apnea, heart disease, type 2 diabetes, and hypertension so there is no shortage of co-morbidities. Are these supervised diets something the insurance company springs on a person after all the other requirements are met? Did everyone else have the supervised diets listed in the requirements in their policy? Sorry to be negative, but I am worried that I may be dead in six months.

DrHekier · February 4, 2007

The 'supervised diets' sometimes mean that your weight loss program must have been supervised by an MD. If that were the case, you may need to visit your physician monthly and have them document each month that yes, you are on a supervised diet, have seen a nutritionist, etc..

SeeMeBeMe2 · February 5, 2007

I'm in the houston area as well, we initially were going with a Dr. close to the house who said it would be months before they even had enough junk to send to insurance. I talked to a co-worker whose wife had the lap-band and recomended her Dr. b/c it took only a couple weeks tops (that depends on insurance). We went with Dr. Felix Spiegel and he was great. He is very busy but he is the best at what he does b/c lap-band is all he does. We have United Healthcare and they approved us no questions and it took about a week. They covered 90%. Dr. Spiegel has a website

http://www.felixspiegelmd.com/index.asp

His entire staff is banded and very knowledgable about the insurance stuff works and how to get an answer quick. It helps though if you know your policy b/c at first they said its an exclusion but I had read my policy and knew they approved obesity surgery if you have a BMI over 40 (or 35 with a co-morbidity). He works through University General Hospital which is awesome and half the staff there had obesity surgery of some kind and were happy to lend advice. Good Luck to you and I hope it works out!