Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Recommended Posts

Who is it that decides whether or not a person has to do the 6 month nutrition class? Is it the Surgeon or the Insurance company?

Share this post


Link to post
Share on other sites

Sometimes it is the doctor, but usually it is the insurance company that is driving the 6 month diet trial.

Share this post


Link to post
Share on other sites

Who is it that decides whether or not a person has to do the 6 month nutrition class? Is it the Surgeon or the Insurance company?

It's not really a diet trial or nutrition class. "It's a six month opportunity for you to change you mind or give up and the insurance won't have to pay" - trial.

Share this post


Link to post
Share on other sites

Who is it that decides whether or not a person has to do the 6 month nutrition class? Is it the Surgeon or the Insurance company?

My surgeon's office followed what my insurance dictated. At first they required the 6 month supervised diet. About 2 months in, that requirement was dropped and I could move forward.

Good luck!

Edited by JerseyGirl68

Share this post


Link to post
Share on other sites

My insurance dictated the 6 months of classes that are required before. What I find interesting is that the surgeon decides if the sleeve or bypass is the proper surgery for you....after only one visit!! Im glad that they said that we get to have some say in the matter, but the surgeon can override us after only one meeting.....I just hope my surgeon thinks that the sleeve is the better choice for me!!

Share this post


Link to post
Share on other sites

I spoke with a representative regarding the list of requirements I'll need to get done and they have been acting like they work for dang secret service or something. Just keep telling me to wait until my surgeon submits the auth and ill find out then. They wont give me any info at all and its becoming very frustrating. :( I just feel like I could at least BEGIN the nut classes instead of waiting another month if I was sure its required

Share this post


Link to post
Share on other sites

I was NOT aware that the surgeon decided which surgery is best for you! Lap and is definitely outta the question for me, and the RNY is not something I've considered, just because its so complicated, however, I suppose in would go with it if I had no other option

Share this post


Link to post
Share on other sites

I think every insurance and situation is different....my insurance still technically offers that lap band, but they have made it very clear that they do maybe one a year and it really isn't an option. I have Kaiser and even they way that they do things from county to county here is different. My sister did the Kaiser program and had 3 months of classes, while Im doing the same program and have six months of classes just because Im one county south of her and thats how they do it here.

The waiting can be good to. gives you time to wrap your head around everything. In my sisters classes, there were actually quite a few people who lost weight while in the classes and opted out of the surgery cause they felt they had a good jump start on the weight loss (or they couldn't give up soda and just quit :)

Share this post


Link to post
Share on other sites

My insurance company required that I completed a 6 month supervised diet program with a physician or dietitian.

Share this post


Link to post
Share on other sites

It's not really a diet trial or nutrition class. "It's a six month opportunity for you to change you mind or give up and the insurance won't have to pay" - trial.

EXACTLY !!!!!

Share this post


Link to post
Share on other sites

Does anyone ha Bcbs of ks? My doctor wrote a letter telling them I have reflux sugar levels are messed up and. My blood pressure was up. I hope that is all it takes. I thought they had to have documents of it all

Share this post


Link to post
Share on other sites

Does anyone ha Bcbs of ks? My doctor wrote a letter telling them I have reflux sugar levels are messed up and. My blood pressure was up. I hope that is all it takes. I thought they had to have documents of it all

This is interesting! Is it possible to push an approval through if something like that happens? I know there is a criteria that must be met before most insurance companies that DO cover it will even consider it. But what about the ones that don't cover it at all? Can it be a situation where "this needs to happen or else"?

Share this post


Link to post
Share on other sites

Hi all, I have BCBS of MI and I am required to do a 6 month nutrition evaluation/weigh in, sleep study, receive a letter of support from my pcp, & psy evaluation. Nutrition eval could be omitted if I had 6 month documentation from a medical professional.

I'm truly grateful for the waiting period. You really have to train your body for the lifestyle change.

Share this post


Link to post
Share on other sites

Hi all, I have BCBS of MI and I am required to do a 6 month nutrition evaluation/weigh in, sleep study, receive a letter of support from my pcp, & psy evaluation. Nutrition eval could be omitted if I had 6 month documentation from a medical professional.

I'm truly grateful for the waiting period. You really have to train your body for the lifestyle change.

I also have BCBS of Michigan. If you go with St. John hospital, I think the wait maybe less.if that's an option for you. I am going with St. John and the only hoop that I have to jump through is have an approval by my regular doctor and then submit for approval. Hopefully, I will be having surgery in the next 3 weeks.

Share this post


Link to post
Share on other sites

I am going through St. John Macomb-Oakland. That's interesting, you don't have to jump like I did. Do you have documentation of you weight for 6 months?? That's is the only exception I am aware of.

I'm scheduled 3/14! Good luck to you =)

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • vsg.with.sharon

      Hey everyone!
      I’m new here! Looking for some friends! 🥰
      · 0 replies
      1. This update has no replies.
    • LeighaTR

      Four days post surgery. I am sipping as fast as I can and getting NO WHERE near the goal of 60 - 80 grams of protein or the 64 oz of liquids. I just feel FULL. I don't know if it can still be the gas build up (I would think by now that would be gone) but it is a struggle to drink. And so far I have not had the nausea or spasms and don't want to wander into that territory by pushing too hard with liquids. I about passed out today as it was my most "strenuous" day. Went from second story to basement for shower and I was sure I was going to pass out. Looking back on my last few days I have had a total of less than 1000 calories. Am I just not getting enough nourishment in me? Once again a friday where I can't get ahold of the doc until Monday rolls back around so I am hoping maybe someone here has some experience on how to keep energy going. I do have fibromyalgia too and that may be where some added fatigue comes into play. How did you all fair with the goals the week after surgery?
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      2 days until I fly out to San Diego to have my Bypass Surg. in Tiajuana Mexico. Not gonna lie, the nerves are starting to surface. I don't fear the surgery itself, or the fact that I'm traveling alone, but its the aftermath that I'm stressing about the most, after this 8 week wait. I'm excited to finally be here, but I am really dreading the post surgical chapter. I know its going to be tough, real tough and I think I'm just in my head to much now that the day i here. Wish me luck, Hopefully I'm one of the lucky ones, and everything goes smoothly. Cant wait to give an exciting update,. If there is anyone else have a June bypass or even a recent one, Id love to have someone to compare war stories with. Also, anyone near San Antonio Tx? See ya soon with the future me. 💜
      · 3 replies
      1. Phil Penn

        Good Luck this procedure is well worth it I am down to 249.6 lb please continue with the process..

      2. Selina333

        I'm in Houston so kind of near you and had the sleeve in Dec. Down 61 lbs. Feeling better. Was definitely worth it. I hope the everything is going well for you. Update us when you can!

      3. Doughgurl

        I am back home after my bypass surgery in Tiajuana. I'm post op day 4. Everything went great! I guess I'm one of the lucky ones who have not encountered much pain at all, no nausea thus far and I'm having no problem keeping down broths and water. Thank you for your well wishes. I cant wait to keep up this journey and have a chance at better health and simply better quality of life. I know there will be bumps in the road ahead, and everything won't be peaches and cream, but at least I have a great start so far. 😍

    • LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 2 replies
      1. Selina333

        I'm so happy for you! You are about to change your life. I was so glad to get the sleeve done in Dec. I didn't have feelings of regret overall. And I'm down almost 60 lbs. I do feel a little sad at restaurants. I can barely eat half a kid's meal. I get adults meals often because kid ones don't have the same offerings at times. Then I feel obligated to eat on that until it's gone and that can be days. So the restaurant thing isn't great for me. All the rest is fine by me! I love feeling full with very little. I do wish I could drink when eating. And will sip at the end. Just a strong habit to stop. But I'm working on it! You will do fine! Just keep focused on your desire to be different. Not better or worse. But different. I am happy both ways but my low back doesn't like me that heavy. So I listened (also my feet!). LOL! Update us on your journey! I'm not far from you. I'm in Houston. Good luck and I hope it all goes smoothly! Would love to see pics of the town you go to for this. I've never been there. Neat you will be traveling for this! Enjoy the journey. Take it one day at a time. Sometimes a few hours at a time. Follow all recommendations as best you can. 💗

      2. Doughgurl

        Thank you so much for your well wishes. I am hoping that everything goes easy for me as well. We don't eat out much as it is, so it wont be too bad in that department. Thankfully. Also, I hear you regarding your back and feet!! I'd like to add knees to the list. Killing me as we speak! I'm only 5' so the weight has to go. Too short to carry all this weight. Menopause really did a doosey on me. (😶lol) My daughter also lives in Houston. with her Husband and my 5 grand-littles. I grew up in Beaumont, so I know Houston well, I will be sure to keep in touch and update you on my journey. I may need some advice in the future, or just motivation. Thank You so much for reaching out, I was hoping to connect with someone in the community. I really appreciate it. 💜

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×