Insurance requires 6 months to try to lose some weight

[Carrie Briggs 0]

Hi there. I am brand new here. My insurance, UnitedHealthCare, required me to wait 6 months to TRY to lose some weight, but they don't say how much. I'm not afraid to lose too much to be Unqualified, as I have high blood pressure (on medication) and I am diabetic now (on Metformin) and I have terrible G.E.R.D. (on medication). So even if I lose 15 lbs I will still qualify. I am currently 215 lbs at 5ft. 1"

I am a bit scared of the sleeve surgery, as I'm afraid I will vomit every time I try to eat normally.

I am so sick of being so overweight, so I do want this surgery. I eat from BOREDOM for sure. The TV and Snacks go together, but I'm often very hungry as well.

I am embarrassed and don't want to tell anyone except my husband and my boss (because I will be out for 4-7 days from work)

I want to meet others In New Jersey going through the waiting process, due to insurance. It would be nice to talk to others going through this. So far I've lost maybe 3 lbs.-4lbs It's been almost 2 months. I go to the doctor on Jan 5th for the 2nd required appt for weight loss logging. I will admit when I went for weight loss logging the first time, I stepped on the doctor's scale with my heavy motorcycle boots on and heavy denim jeans and a thick sweater. I weighted 219 lbs! Ha-ha. I was trying to. At home I had weighed 215. So when I go back on Jan. 5th I will probably be about 212, if I take off my shoes and wear lightweight clothing. ha-ha. But I really did lose about 3-4 lbs.

Then in early February I go for the third weigh-in and I have to lose another pound or two. It's so hard. I eat so many veggies.

Carrie

[Babbs 14,680]

FYI, I had the surgery 16 months ago and haven't thrown up once. Most people don't if you're careful not to overeat.

Also, because I was trying to quit smoking, I had only lost 5 pounds during my 3 month weight loss insurance requirement. As long as they see you're making an effort, you should be okay.

[MsAshley0307 19]

From my experience they don't require a specific amount of weight to be loss, but want to see something steady to show you can follow a program of some sort.

My cousin and I both went through the process. We both had concerns about losing too much weight, but it was told to us that it's better to lose what you can in order to have a safer procedure so I would recommending asking your doctor/surgeon more questions on it.

Don't get too comfortable eating everything you want to shrink your liver and not have complications.

Edited January 2, 2016 by MsAshley0307

[shanikavsghopefull 1]

Hi I have to so the 6 month diet to so we will probably be sleeved around the same time

[IansmommyRVA 39]

Hi, I am new here too, I have Anthem and it also requires 6 month waiting/dieting period... so, we will probably be June or July sleeves =)

[smarcelin2014 5]

I had to go through the 6 month requirement. My insurance didn't specify how much I had to lose, to be honest when I started my journey in December 2014 I was at 295, today about 3 weeks pre op I hover around 310-320. So I essentially gained weight. I was scared that I wouldn't be approved but I guess all they needed was to see that I did try and along with my co-morbidities that it was a no brainer approval.

Edited January 3, 2016 by smarcelin2014

[gingeryank 37]

Hi, Carrie. I'm new here, and it looks like we have some things in common: same height, 212 at my last weigh in, and United insurance. I go for my WLS consultation on Tuesday. I haven't decided if I'm going to use United or self pay, but if the surgeon approves, I'm getting sleeved per my PCP's and GI's suggestion. Good luck to you! ~ginger

[cindyw41 761]

Started this at 215lb, I'm 5'2"

During my 6 months supervised diet my nut told me not to lose more than 13 lbs. I watched what I ate, exercised some and lost 8 lbs. My insurance approved me in 24 hrs.

My doctor's requirements were to lose, maintain or not gain more than 5.

Use these 6 months to develop good eating habits. See if your hospital or dr has support groups.

Most Drs won't start your 2 week pre-op until you're approved. Then all bets are off, stick to their program so that you shrink your liver. I will say making the good food choices in the 6 months before has my mind prepared for after.

[Ryan TN 348]

9 weeks post op here. I had a 3 month medically supervised diet plan with my doctor to meet Cigna's requirements. As of 2 days ago, I'm now under united. I think the weight loss plan requirement is more of a formality than anything else. Im sure theres a small percentage of people who would go thru the diet and chose not to have the surgery. Lets be real for a minute, our insurance company could care less about us, so they would probably prefer not to have to pay for the surgery if they can. The requirement is probably for that purpose. My bmi was not real high when i went to the surgeon, and i was a little concerned what if i lost too much weight under the 3 month plan. They said it didn't really matter, it was my weight on that first visit that counts. Good luck, how do you like United?

[southernbelle256 101]

I gained 32 lbs during my 6 month wait (which turned into 11 months for various reasons) ????????. I started the process at 212 (I'm 5'1") and I was 244 when I had surgery.

I was still approved.

I'm 4.5 months out now and down 65 lbs. I wish I hadn't gained all that before surgery but I'm glad to be rid of it now.

I have only thrown up twice 1 time because I could not handle a crushed medicine right after surgery ???? and the other was because I drank immediately after eating a meal without thinking.

My only regret is not doing this surgery sooner.

[mykdzmom 387]

6 month supervised weight loss was required for my insurance as well. I lost then gained a few pounds in the end and like southernbelle256 wish I hadn't.

The time will pass before you know it. I would suggest you try to get cardiac clearance and pulmonary (sleep apnea) appointments made as soon as possible. I ran into delays because I ended up having sleep apnea and needing a heart cath. Both added second and third visits which added 6-8 weeks to the wait.

I also chose not to tell anyone, but to each is on.

I have no problem eating and only had one time that I also drank after eating and the Water came back up.

I knew when I woke up from surgery it was the choice for me. I am loving my sleeve.

Good luck on your journey!

[shanikavsghopefull 1]

Hi, I am new here too, I have Anthem and it also requires 6 month waiting/dieting period... so, we will probably be June or July sleeves =)

are u on fb there is a really good support group

[IansmommyRVA 39]

Hi, I am new here too, I have Anthem and it also requires 6 month waiting/dieting period... so, we will probably be June or July sleeves =)

are u on fb there is a really good support group

I don't have Facebook... that's why I ended up here at bariatricpal... thank you for the info though. I really enjoy reading all the encouraging words and the inspirational stories... you guys rock here!!

[twin463 0]

I also so have Anthem my first appt. Is monday currently I do use a cpap machine have sleep apnea guess I will be looking at six months also like Sept.

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[ACV 34]

My insurance requires 3/6 month supervised diet. My Dr put me on diet pills a little over a month ago and I have lost 21 lbs as of the 24th of Feb. I am changing my eating habits because I have to for surgery and I just found out I'm diabetic, but is that a problem that I am doing well on my new low carb diet? If I continue to lose weight like 10-20 lbs a month am I disqualified? I'm able to because of the diet pills. I can't stay on them forever. What should I do? What would you do?

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