Any exception to 6 month waiting period?

[kelliev2015 136]

Hi, I was wondering if anyone has been able to get an exception to the insurance waiting period? I was planning to self pay but when I found out my insurance might cover it, I decided to look into it. Obviously I want to save myself 20K but really didn't want to wait any longer. I have Premera insurance specifically but would be interested to hear if anyone has had any luck with that, regardless of the insurance plan. I've seen a few things where the waiting period was waived but no one said how. Thanks in advance.

[MsLola24 12]

Mine is 3 months. Started the process in Sept and surgery is Jan 12. Insurance approved and ready to go.

[2goldengirl 2,076]

I've never heard of your insurance company, but the best way for you to know is to contact your insurer, and ask to speak to a supervisor. Ask the question. You can also ask your surgeon's office to see whether they have been successful getting waiting periods waived.

[Miss Mac 6,262]

If you can't get it waived, then consider that period of time to be a part of the learning process. You will learn new habits that will benefit you greatly post-op. I had a three month supervised diet and was glad of it. Post-op, I was prepared to start my new way of living with confidence, since every change I needed to make was already a habit. Beside, it will give you a chance to lose some weight and you will be ahead of the game. The time is not wasted.

[roxiijess314 2]

I know this is a late post but mine was waived because my bmi is 50 or higher...

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[Valentina 2,642]

A woman I know had the waiting period waived because she had to have a hernia repair that could not wait.

What does your surgeon say? Is she/he willing to waive the waiting period? Mine would not because HE wanted to see some commitment to the process.

Good luck and keep us posted. Good information to be able to pass on.

[kelliev2015 136]

My surgeon doesn't agree with it. He looks at it the same as if you had cancer and the insurance company made you wait 6 months for treatment. I'm lucky in the sense that my BMI is low enough that I likely won't have any major health problems during that time but that may not be the case for other people. I think it is really stupid that they make you wait 6 months to get healthy. I appreciate all of your responses and am just going through the steps. I am 2 months into the 6 months and am hoping it goes by fast!

[prettyCali916 299]

Mine technically wasn't waived - I just told them I had done a liquid diet for 5 months in 2013. They said it was good enough and after my consult on 1/7 my paperwork was sent in on 1/11 and I got approved on 1/13. Had surgery on 2/1!

[2bsleeved26 18]

^^^they didn't make you provide any proof of the liquid diet attempt ?

[prettyCali916 299]

I volunteered it. I just called Kaiser and they emailed me the 5 month weigh-in logs and the labs and I forwarded straight to my surgeon's office.

[kelliev2015 136]

Wow. That's great for you. I think my insurance is a lot more strict according to my surgeon's office. Glad it worked out for some of you! I hope you are making good progress!

[Kidbxrs 2]

I have a 3 month doctor supervised diet program to complete before insurance approval. I actually have my first of 3 visits tomorrow afternoon. My delima is this.....My BMI is 42 and if I fall below 40 I have to have another morbidity to be approved. I have lost weight and gained weight so many times before and if I thought this would work then I wouldn't need surgery. Has anyone delt with anything like this?

[VDLT 244]

I didnt have a waiting period because I was a conversion with complications. I was going to go the self pay route if not but so glad it was covered. Not only for the money saved for the surgery itself but what if I had any complications or problems? I was worried those would not be covered if I went self pay and they happened.

Honestly if you only have 4 more months to go, it will go so fast and it wont matter a year or so from now. I understand wanting it now but honestly, it won't matter down the road...

[kelliev2015 136]

@@Kidbxrs, I am in the same boat! My BMI is 36 and I lose my benefit if I fall below 35. My nutritionist told me exactly how many calories I should eat to maintain my current weight. They see this all the time and can help you come up with a diet that will keep you stay where you are minus a few pounds. If you drop below 40 BMI, just wear ankle weights to your last weigh in! Haha. (Kidding) ????

[Kidbxrs 2]

@@kelliev2015 HAHAHAH I like your way of thinking.... I had already thought of doubling up on clothes if I lose.... Great minds think alike.