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Insurance Requirments

I have been reading a lot of your post and it seems that most usually have 8 to 9 month process leading up to surgery. I know some of this is because pre op testing, but I was wondering if this is also because the insurance required a 6 month diet program? I know a lot of them do so I was wondering if the 8 or 9 month process included this for most of you. My insurance doesn't require this so I'm just trying to get an idea.

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I was worried about that too' date=' that's what my insurance wants as well. no diet but 5yr weight history! I also avoided doctors but I was told by surgeons office that any documented weight history is fine, weigh watchers, they gym, any will do and all you need is one for each year. I was pregnant in 2008-2009 but I still used my pregnancy weight history which actually helps..lol good luck, I hope the best for ya![/quote']

Thanks! I appreciate the input. I did join WW on a few different occasions and one other weight loss plan that I may be able to come up with. Thanks again

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All I know is that after researching WLS like mad' date=' and especially after spending endless hours here, I want to bop anybody who says having WLS is the "easy way out." I don't care if you're going the insurance route, the self-pay route - this is a hard process regardless of how you pay for stuff.[/quote']

There are always going to be people who judge. I always say if you haven't walked a mile in my shoes then don't pretend like you know what I go through. I have been over weight all my life and have tried all different types of method to loose weight. I have also researched WLS quite a bit and it is a life style change and takes hard work and commitment. But the end result is so worth it.

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I am wishing for a smooth outcome lol. I have my 5yr weight history' date=' all but two more appoints are done, blood work and EKG done, and trying not to lose even one pound because I guess Im right at the border line with my BMI, if it gets lower (under 40) then I have to have comorbidities (which I do not have). but I am still 250lbs and ready to start this new year coming as a healthier, happier, skinnier me!![/quote']

Isn't funny how if you try to lose weight it never goes anywhere but if you don't want to it falls off. Lol Good luck!

I am wishing for a smooth outcome lol. I have my 5yr weight history' date=' all but two more appoints are done, blood work and EKG done, and trying not to lose even one pound because I guess Im right at the border line with my BMI, if it gets lower (under 40) then I have to have comorbidities (which I do not have). but I am still 250lbs and ready to start this new year coming as a healthier, happier, skinnier me!![/quote']

Good luck to u as well. Sounds like u have everything in order! Hope to see you post your surgery date soon as well.:)

Isn't funny how if you try to lose weight it never goes anywhere but if you don't want to it falls off. Lol Good luck!

exactly!! it took me over 4mo once just to lose 20lbs. I recently went through a separation and for some reason don't have much of an appetite ( which is unusual for me) so its been hard to try and keep the weight on, at least until I meet with surgeon, from what his office told me, that's the weight that matters and is being sent to insurance company. it sounds horrible I know..."oh I cant lose even one pound"....but to me this surgery is everything! sure, anyone can lose 5-10lbs but its those of us who are 100lbs or more over weight that have a hard time losing ALL we need to lose. it kinda upset me when she said " don't lose any weight until after you meet with surgeon when your done with all your appointments". it really sucks being on the boarder with your weight!!

I don't blame you for being worried. I would be too bc you know how insurance companies can be. Just continue to think positive and I believe the outcome will be positive. My biggest worry is the portion of the surgery I will be responsible for. My insurance will pay 80% and I'm responsible for the other 20%. I won't know until the 22nd how much that will be. Good luck on your endeavor! :)

don't know if this helps but mine pays 80% as well and my portion is about $1,200 but the surgeons office said that you are billed by the hospital and you can do payments!!!!!!

Good luck to u as well. Sounds like u have everything in order! Hope to see you post your surgery date soon as well. :)

THANK YOU!!! I hope things go good for you as well!!! maybe we will see each other on the "losers" side! lol

I was 3months of office visits and 30days for approval but that turn into to15 day and they approve and my surgery date was set the next week and that was July 8

Hi honey

What is your Health Insurance & plan (:

I went to my seminar on July 19, got my surgery date of Sept 16. I had no diet requirements. I did have to meet with the nut and psych which I will finish this week, then insurance has to approve me. I am nervous about that but from my review of insurance requirements, it seems like I will have jumped through all the hoops that they asked. It is so hard to be patient.

  • Author

exactly!! it took me over 4mo once just to lose 20lbs. I recently went through a separation and for some reason don't have much of an appetite ( which is unusual for me) so its been hard to try and keep the weight on' date=' at least until I meet with surgeon, from what his office told me, that's the weight that matters and is being sent to insurance company. it sounds horrible I know..."oh I cant lose even one pound"....but to me this surgery is everything! sure, anyone can lose 5-10lbs but its those of us who are 100lbs or more over weight that have a hard time losing ALL we need to lose. it kinda upset me when she said " don't lose any weight until after you meet with surgeon when your done with all your appointments". it really sucks being on the boarder with your weight!![/quote']

It doesn't sound bad to me. Anyone who has ever struggled with weight knows you may lose 10 or 15 pounds but it usually comes back with a vengeance. WLS is not only about losing weight but keeping it off.

  • Author

don't know if this helps but mine pays 80% as well and my portion is about 1' date='200 but the surgeons office said that you are billed by the hospital and you can do payments!!!!!![/quote']

Thanks! That defiantly helps give me an idea of what my portion will be. I do know that my surgeon requires for you to pay all his fees upfront, but I can make payments on the hospitals part. But if my portion of his fees are around $1200 then it won't take me as long to pay that off. I was very fearful that it would be a lot more than that. I know that mine still could be more bc every surgeon is different. But that does help give me an idea. Thanks again! :)

  • Author
I went to my seminar on July 19' date=' got my surgery date of Sept 16. I had no diet requirements. I did have to meet with the nut and psych which I will finish this week, then insurance has to approve me. I am nervous about that but from my review of insurance requirements, it seems like I will have jumped through all the hoops that they asked. It is so hard to be patient.[/quote']

I agree SuzyB that waiting and trying to be patient is difficult. This procedure means so much to us and the effect it will have on our lives is so important. It's hard not to get excited about it.

I went to my seminar on July 19, got my surgery date of Sept 16. I had no diet requirements. I did have to meet with the nut and psych which I will finish this week, then insurance has to approve me. I am nervous about that but from my review of insurance requirements, it seems like I will have jumped through all the hoops that they asked. It is so hard to be patient.

You got your surgery date at the seminar? Your requirements sound similar to what mine will be.

Well more accurately, I had my first surgeon appt the same day. At that appointment is where I got my surgery date. The practice I went to, sets up seminars every Thursday and Friday and then has lots of the prospective new patients meet with the surgeon after that appointment.

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