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Insurance question

I have preathorization for medical necessity from my insurance to get the sleeve. I'm scheduled to be sleeved on October 5th and attended a preop class last night (required for patients at my doctors office prior to surgery)

At the class the nurse went over what to expect on surgery day. She said they weigh you at the hospital both for anesthesia (makes sense) and "for insurance" So now I'm nervous that if I lose weight during a preop liquid diet that it might change my qualification for insurance.

Is that something that could happen despite preathorization??? I don't want to wake up from surgery and find out I have an enormous bill to pay. Worrying a little. I'm a 42 bmi so technically because of several comorbidities. I could drop as low as 35 bmi and still qualify, I think. But I'd rather not test that theory.

My doctor doesn't require a liquid diet preop unless you have a Bmi over 50 but I was going to do it for a week anyway. Maybe I shouldn't?

Thoughts from anyone?

Thanks!

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  • You should not have any problem with this. It will be more difficult than you think to lower your BMI below 40 that quickly. Also once you have the authorization I have never heard of it getting pul

  • Thank you all! I'm feeling much better about this now. I think as I'm getting closer to the surgery date I'm finding more little worries cropping up. It's exciting but nerve wracking!

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You should not have any problem with this. It will be more difficult than you think to lower your BMI below 40 that quickly.

Also once you have the authorization I have never heard of it getting pulled because you lost too much weight on the preop diet. Also you will likely gain all that you lost on the preop diet back in the hospital. It is very common from all the fluids they pump into you.

I would not worry about this at all.

Once you are authorized you are good to go. I had lost 9lbs prior to surgery and did drop 1 bmi point. It doesn't matter if you lose after the authorization. It's only to document.

By this time you are already approved and the insurance company should know the bariatric routine.

Keep in mind that the liquid diet phase is to reduce the fat on your liver so the doctor can have access to your stomach. I'd hate more if I got there on surgery day and they have to postpone because I didn't lose enough.

Ask your Doctor about it. I'm in your same position and he said my pre-op appointment with him would be my final weigh in!!! He knows I'm on that fence my ins covers 35 and above and I'm at 38!

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Thank you all! I'm feeling much better about this now. I think as I'm getting closer to the surgery date I'm finding more little worries cropping up. It's exciting but nerve wracking!

Do you mind me asking what insurance company you got approval through? My current insurance doesn't cover it and I'm thinking of taking out a secondary policy that does but I don't know the companies that do cover it. Thanks!

Do you mind me asking what insurance company you got approval through? My current insurance doesn't cover it and I'm thinking of taking out a secondary policy that does but I don't know the companies that do cover it. Thanks!

see if this helps: http://www.bariatric-surgery-source.com/lap-band-insurance.html

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