Getting Started! Insurance Requirements for Surgery...

[Jennifer2322 10]

Hi everyone! My name is Jennifer, and I am just getting started on my weight loss journey. I have a looooong road ahead of me, and I know it won't be easy. I have struggled with my weight my whole life, and I am so tired of it! I am the heaviest that I have ever been. My first Bariatric doctor's appointment is 4/8, and it cannot come quick enough! I'm so ready to get this going!

I have a question... one of my insurance requirements is that I take part in a medically monitored weight loss program prior to surgery. I contacted my insurance and found out that Weight Watchers is ok to use to fulfill this requirement. I'm not sure whether I should sign up for the Online Plus program or for meetings. The meetings do not sound appealing to me at all, I have attended them before, several years ago and there was always someone whining about this or that. I don't do well with whining!!! However, I think a group support would be great, as long as there were not any whiners! The online plus sounds very convenient and is a lot cheaper! Has anyone used Weight Watchers to fulfill the 6 month medically monitored weight loss requirement? Did you do it online or with meetings? What was your experience like? Also, does anyone know why this is a requirement? I think it seems kinda silly, but of course I am just super anxious to get the ball rolling and don't want to wait 6 months!!! I have tried so many diets and weight loss programs, I'm so scared of failing again.

I would love to hear stories about your weight loss journey both before and after surgery! :-)

Thank you!

Jennifer

[Crosby 303]

My insurance required my monitoring to be by a medical person which for most people ends up being your PCP. Frankly I don't understand why they would tell you Weight Watchers would be okay since you are not "medically" monitored by them. I would not consider it as an option unless they put it in writing. I got more than one bit of inaccurate information from customer service reps from my insurance company. Your surgeons office may be a more reliable source on what is required.

[Jennifer2322 10]

@@Crosby, I know, I found this to be very odd too. But I have checked with my surgeon's office and I have called my insurance company at least 3 times to double-triple check, and spoke with a different customer service rep each time. Even my physician told me this when I went to him to obtain a referral to begin this process.

[MrsB2007 90]

Usually the ins requires your weight to be checked, BMI etc each month. Not sure how it would happen online vs in person. Many times they need to see caloric intake, food journals, exercise etc. I would do a pcp if possible.. if they're okay with weight watchers make sure to ask the ins co what is specifically needed to be documented by weight watchers to qualify as medical supervised weight loss

[Crosby 303]

If WW indeed is okay I don't see online being sufficient as there really is no monitoring....you could input anything. I did online for four years so I amfamiliar with it. It would possibly even be cheaper, with insurance, to go the PCP route.

[Martene81 383]

I really don't see how WW would be accepted as medically supervised seeing how there is no medical professional supervising you.

What insurance do you have?

Maybe they meant that they would accept WW as a "documented weight loss attempt" which most insurances require and want notated somewhere in your history.

As far as the medically supervised diet required prior to surgery; it has to be overseen by a Dr and is usually 3 or 6 months sometimes 12.

I would just go to either your pcp or a multidisciplinary Bariatric team to oversee your diet to avoid being disappointed in the end.

[Summer Rain 245]

Hi Jennifer! Just wanted to let you know that I did WW online but I also saw my PCP once a month just to get weighed and discuss calories, exercise, etc.

Good luck!

Summer

[Daisee68 2,493]

Not sure what insurance you have but I have Cigna and specifically it says "

"Medical management including evidence of active participation within the last 12 months in a weight-management program that is supervised either by a physician or a registered dietician for a minimum of three consecutive months ((i.e., ≥ 89 days). The weight-management program must include monthly documentation of ALL of the following components:

 weight

 current dietary program

 physical activity (e.g., exercise program)

Programs such as Weight Watchers®, Jenny Craig® and Optifast® are acceptable alternatives if done in conjunction with the supervision of a physician or registered dietician and detailed documentation of participation is available for review. "

You might ask your insurance company for a copy of their requirements, but it is likely fairly similar - in that you will have to have it verified by a physician or dietician.