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Ok so I just attended the information session yesterday and I'm pretty much ready to do it like yesterday but my insurance requires 4 or 6 month supervised diet (wasn't very clear) . My question is since My BMI is 41 so I'm borderline meeting the requirement if I lose weight on the 4 or 6 month supervised diet and it drops under the 40 BMI requirement will that mean that I no longer qualify? Do they just use your initial BMI when they submit to insurance or do they use your BMI from your last nutritionist appt?

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I just did not loose weight on my supervised diet. which was ok too. I had Federal BCBS.

do you have comorbidities?

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My surgery center said it was based on your bmi on your initial visit. Check with yours to see though.

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My coordinator told me that the first weight matters only, so make your your extra heavy your first consultation. That being said your surgeon or coordinator will tell you whether or not your insurance will be affected if you go under 40 BMI so be sure to ask!

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My office said that I didn't need to lose any weight during the 3 month period. Maybe it is insurance dependent.

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As per my doctors office, in order to qualify, I need to maintain a bmi of 40 and above. If I go below that then the requirements change. The best bet is to call your insurance and verify with them, is it 4 months, or 6? Is it the initial visit? of the last? I work in a hospital and I deal with insurance companies to obtain pre-authorizations for procedure and I can tell you they will deny, deny, deny for the littlest, dumbest sh!t.

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My Dr said initial weight but my insurance said do not drop below 40 BMI

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Ok so I just attended the information session yesterday and I'm pretty much ready to do it like yesterday but my insurance requires 4 or 6 month supervised diet (wasn't very clear) . My question is since My BMI is 41 so I'm borderline meeting the requirement if I lose weight on the 4 or 6 month supervised diet and it drops under the 40 BMI requirement will that mean that I no longer qualify? Do they just use your initial BMI when they submit to insurance or do they use your BMI from your last nutritionist appt?

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Make sure to ask this specific question to not only your bariatric center but also your insurance company.....because it is different for different plans. as you've seen in the previous answers sometime just the initial weight is used....but for me every single weigh in counted until they finally submitted to my insurance for approval.....I was like you and started out with a BMI of around 41 and I had to make sure I did not drop below 40 prior to being submitted to my insurance.

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My coordinator told me they use the weight after the supervised diet to supply to insurance for approval. She told me not to lose more than 30 pounds during this time or I would be under the 40 bmi.

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My surgeon said its your weight at time of consult with him... To me that makes sense, if your on a diet your going to drop some weight most likely... Most obese people have little problem dropping weight, it's keeping it off that's the problem.... The insurance thing is the most frustrating part of the journey, we have a disease and were left wondering if we will be approved for treatment... It's just so wrong!!!

"We can't solve problems by using the same kind of thinking we used when we created them"

Einstein

Edited by nyteacher125

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
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    • KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
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      https://alluniqueguide.com/java-burn-coffee-reviews/
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