Hi all. I started the process for the surgery in June. My insurance requires 6 months of weights- that puts me on track for a November surgery. The office I went to the coordinator said I shouldn't lose or gain more than about 7 pounds from now until the surgery. I'm a little concerned about this. I want to eat healthier and I don't necessarily lose weight easily but I'm worried about losing more than 7 pounds. I have about 150 pounds to lose and can't do that on my own so I definitely need the surgery. Will I be denied if I lose more than 7 pounds. Like let's say even 10. Shared Experiences welcome!!!!

@@dommie20 I'm curious about this too. I also have to do the 6 month deal. I'm do for surgery in January. However, when I had my first appointment(July 7th) there was no mention about gaining or losing. I"ve heard people say they were denied for losing too much :-/

I also had a 6 month requirement and my insurance also required to lose 5% of my weight or I would not qualify. I lost the 5% and my doctor is submitting me for approval on Monday, has my last weigh in and pre op with the doctor Saturday, and my surgery has been scheduled for 7-30 pending insurance approval..so wish me luck

I'm curious, who is your insurance companies? I'm still waiting to hear from mine.

I'm curious, who is your insurance companies? I'm still waiting to hear from mine.

My insurance is through BCBS Excellus

My insurance only required 3 Months of supervised diet. Though I had to journal everything (my co-workers would tattle on me if I didn't), I ended up loosing 21 pounds my last appointment before they scheduled my surgery. I was told by the surgeon that I would have to loose at least 15 pounds before he would even consider doing the surgery. Staff advised that I shouldn't gain any weight. Every 30 days I was in the office with my food journal and was told what things to modify.

I have never been told not to loose a certain amount of weight prior to surgery. But I started out at 424 pounds too. This may be a requirement for your insurance. Have you questioned the staff on this any? I am sure you would have no problems getting an answer from them.

My insurance company is bcbs of Illinois.

I have BCBS in California. They only require a psych evaluation & 6 month diet. I was so bummed to wait 6 months, but everyone keeps telling me it will go fast.

Hi all. Thanks for your input. It's not the 6 month wait I'm concerned about. I'm worried about the weight threshold I would like to eat a healthier cleaner diet but if I lose too much weight the insurance company won't approve the surgery. I have emblem health. 6 months will fly right by and it gives me Time to really process what I'm doing and prepare myself for what will be a huge life change so I'm ok with that but two weeks before surgery I have to be on all liquids and then I'll have a new stomach and new eating habits. I would like to try now to sort of work myself Into that way of life but if I lose too much I won't be approved. Maybe I should talk to the surgeons office again.

Yes, definitely talk with your surgeon... I'm going to do the same as well.

I agree with you 100% after my initial impatience to the 6 month wait, I started to look at it as an opportunity to really prepare myself. Best of luck

Same to you VSG. keep in touch it's good to have a buddy!!!

I am right at 40 BMI, My surgeon is doing my six month supervised diet. He advised that I weigh right at 40 for my nutrition appointment and then can lose as much as possible. I am looking at Ocober for my six months to be up.

I also have to do 6 months physician supervised dieting. I am 2 months in and it seems like forever. I have went through the blood work, phys eval, ultrasound, endoscopy, I confirmed with my insurance(BSBC AL) that they go off the first initial visit. So they want you to show weight loss. I agree 6 months seems like forever but it will be worth it.

Edited July 22, 201412 yr by tmspears3

Your insurance company should clearly state the requirements. The requirements vary from insurance to insurance.

My insurance required a BMI of at least 35 with two comorbidities or a BMI of 40 or higher. I started losing weight before I even started the 3-month nutrition, but my BMI was still 42 when I was first measured by the bariatric center. My surgeon said most insurance companies use your first BMI measurement to determine qualification. By the end of my 3-month nutrition my BMI was down to about 37, but the insurance still approved me. My insurance did state that I could not gain weight during the 3-month nutrition.

Edited July 23, 201412 yr by AlwaysVegas

Hi all. I did speak again with the bariatric coordinator at my surgeons office and she said it's important I don't lose too much or I'll be denied. So I'm trying to maintain this 278 I'm at right now. I have emblem health. I'm so nervous about being denied!!!!

Typically, they don't want you to gain weight because it shows a lack of commitment to weight loss and insurance companies don't want to pay for something if you're not serious about it. On the reverse side, if you start losing a ton of weight from dieting alone, they figure they don't have to pay for the surgery because you have been successful with dieting and should continue trying that. The need for surgery is because all other options have failed you. I was told not to gain weight, but it was ok to lose some.

Disclaimer: I am insured thru the hospital I work for, so my requirements are very different from the norm since it's the hospital's self-funded insurance that is paying for my health needs (and my own with premiums, copays, and deductibles).

Edited July 27, 201412 yr by Norestrictions08