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Prescribed Post Op Meals?

Hello,

So I spoke with my surgeons office today and scheduled my preop appt. however, they informed me that I will have to pay $3,900 for their post op meal plan. I believe she said it would be a month of supplies. She said that normally the patient pays out of pocket and it doesn't count toward the deductible. I asked her to submit it to my insurance to see if they will cover it so that it will at least count toward my deductible.

Anyone ever heard of this before? I think it is the Optifast program. I have anthem blue cross with SISC II. Does anyone know if prescribed meals are covered? I really don't want to pay 4 grand for a month of food lol

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Hello' date='

So I spoke with my surgeons office today and scheduled my preop appt. however, they informed me that I will have to pay 3,900 for their post op meal plan. I believe she said it would be a month of supplies. She said that normally the patient pays out of pocket and it doesn't count toward the deductible. I asked her to submit it to my insurance to see if they will cover it so that it will at least count toward my deductible.

Anyone ever heard of this before? I think it is the Optifast program. I have anthem blue cross with SISC II. Does anyone know if prescribed meals are covered? I really don't want to pay 4 grand for a month of food lol[/quote']

Wow that is crazy!!! I had to pay 509.00 to get a meal plan from the nutritionist that works with my doctor; but food is not included. I meet with her

monthly to monitor my weight loss & she gives me recipes and a schedule of when I can add certain foods back into my diet. Once I hit 6 weeks post I go for a one in one with a fitness trainer & he will tell me what exercise to do to help me tone. BTW the trainer is included in the package price. Insurance does not cover my cost either, but it's not 3,900. I pray that you don't have to come out of pocket like that!!! Good luck!!!

HW:320 SW:311 DW:320 SD: 7/11 CW 296

  • Author

Ya this is supposed to include all the meals and check ups with the doc.I have a $1200.00 deductible before my insurance pays 90% then once I reach $5000 total out of pocket I'm covered 100%. So if I have to pay I don't mind I just want it to count toward my deductible lol! I would much rather prefer the $500 though!! I just emailed the office back asking if it is optional and how long it will last. (like does it cover 1 year of meals or only 1 month? lol)

I've never heard of that. My nutritionist didn't give me a "plan" more like just guidelines to follow.

Wow that is crazy!!! I had to pay 509.00 to get a meal plan from the nutritionist that works with my doctor; but food is not included. I meet with her

monthly to monitor my weight loss & she gives me recipes and a schedule of when I can add certain foods back into my diet. Once I hit 6 weeks post I go for a one in one with a fitness trainer & he will tell me what exercise to do to help me tone. BTW the trainer is included in the package price. Insurance does not cover my cost either' date=' but it's not 3,900. I pray that you don't have to come out of pocket like that!!! Good luck!!!

HW:320 SW:311 DW:320 SD: 7/11 CW 296[/quote']

Mine covers monthly meetings for 1 year. And I should clarify I don't have a day to day calendar of things she wants me to eat. It's a month calendar of different healthy food suggestions and motivational quotes encouraging me to exercise and healthy recipes! With or without food I would have an issue considering that after 2/3 bites you will be full. Since my surgery my grocery bill for 2 went from 200+ a month to 80.00. So in a nutshell it's a lot cheaper to go and buy your own healthy food from the grocery store.

HW:320 SW:311 DW:320 SD: 7/11 CW 296

Wow, I consider myself lucky, i see the NUT free and just guidelines to follow with my own foods! Im so sorry for you I dont know what I would have done... :wacko:

I have not heard of this and honestly if my doctor suggested it I would have gone shopping for a different doc.

I interviewed two docs and one office had so many hoops for me to jump through it was not reasonable as my insurance only required a psych eval.

That is ridiculous, because those post op meals are non covered by your ins, it will not count towards your deductible or out of pocket .... This shouldn't be a requirement.... My doc had stuff at the office but I wasn't req to buy it..... It was so much cheaper just to go online to get things from injury.com and quest.com and whatever I couldn't order online I bought in the store

Be honest. Tell them that you don't want to or can't afford that.

Requiring you to buy their food is ridiculous. I get seeing a nutritionist but paying $4k cash sounds like a scheme to me.

Hello' date='

So I spoke with my surgeons office today and scheduled my preop appt. however, they informed me that I will have to pay 3,900 for their post op meal plan. I believe she said it would be a month of supplies. She said that normally the patient pays out of pocket and it doesn't count toward the deductible. I asked her to submit it to my insurance to see if they will cover it so that it will at least count toward my deductible.

Anyone ever heard of this before? I think it is the Optifast program. I have anthem blue cross with SISC II. Does anyone know if prescribed meals are covered? I really don't want to pay 4 grand for a month of food lol[/quote']

I have never heard of this! My NUT gave me the option to purchase their Vitamin list and for everything it was $200 but that was a three month supply. You should be able to buy the food outside of the office cheaper. It sounds like a scam to me be careful with that. Even before surgery it no one should spend $3000 on food and you are eating less after surgery!

If that's for Optifast it's crazy expensive! I did the Optifast diet through a Providence hospital for about 9 months. It only cost me between $65 and $90 per week, depending on how much mix and ready-to-use I bought. There was a one time fee of $900 for the program (weekly visits with a nutritionist, a councilor, and a physical therapist) that I was able to pay for with my FSA. BCBS paid for my biweekly doctor visits, weekly PA visits, and all my labs. I lost 80lbs but gained it back over three years (silver lining? BCBS paid for it so I had an undisputable documented failed weight loss - an insurance requirement for my weight loss surgery.)

All I had to pay out of pocket for my RNY was $500 for three educational workshops pre-op and unlimited group meetings post-op.

  • Author

So to give an update:

The official amount for the meals is $3950.00! And it is only a 4 week plan! And it is not optional.

I really trust this doctor (I mean I drive 2 stinking hours just to get to him) but that is ridiculous! I really hope this is a misunderstanding. I emailed the office back again requesting more information and documents on everything. I told them that I do not feel comfortable paying that much money for a month of food.

When I spoke to them on the phone something was mentioned about looking into buying it from costco but its probably not much cheaper. I'm thinking they might just require some sort of meal plan the first month and are just trying to get me to buy from them.

Hopefully I'll be able to sort this out!

I will have a bit more time now as I'm moving my surgery into December. It is currently open enrollment with my insurance. The plan I'm on now is a high deductible plan. If I switch to the 100% coverage plan it will only cost me $3500 a year. On my current plan I have to pay $900 a year but $5000 out of pocket before I get 100% coverage.

My new plan will kick in October 1st so I was hoping to schedule early October. Sadly my doctor is going vacation during October.

Buuuut.. My boss is going on maternity leave later in October! Lol! (We're the only two in our department so I can't leave) so I think early December will be best.

It really works out for the better anyways! By December ill have much more sick time built up, my job will be past the busy season, and I'll have 100% coverage instead of having to pay 5K!

Sorry for the crazy long post. I'll hopefully learn more about this meal thing tomorrow!

I wouldn't pay $4k for 4 weeks of food no matter what. Tell them you have allergies (to being ripped off) or that you are a hardcore vegan.

  • Author

Yea there is no way I'm going to pay that. Basically if my insurance covers it great! If not they need to offer me a more affordable option or ill find another surgeon.

If I'm already approved and I switch surgeons do I have to reapply for approval?

You were approved for the procedure, it should carry to another surgeon. You have established need and they have acknowledged it.

  • Author

Ok great :) hopefully well be able to work this out and I won't have to change surgeons but if I do have to its good to know im still approved.

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