6 month preop requirements

[tholbert08 51]

I am 54 years young and have fought weight all my life. I am in the 6 month period for qualification for my insurance to cover my surgery. I am working hard at starting to develop the habits post surgery now. What if u end up doing just enough that my bmi drops just below qualifying for surgery? Does that happen or do they use your starting bmi as the marker? I am 100 lbs overweight anyway. Thoughts?

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[pleezeSleeve 50]

I too want to know this!

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[audaciousmarie 165]

They use you starting weight when they submit all of your info to the insurance company. The requested weight loss is really to get you in the swing of making the proper changes to be successful post op and to shrink your liver as much as possible so there is no chance they will nick it during your operation.

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[tholbert08 51]

Cool! So the preop weight loss prep just shows we can work the requirements for the surgeon but the insurance still holds for starting weight? COOL!

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[audaciousmarie 165]

Cool! So the preop weight loss prep just shows we can work the requirements for the surgeon but the insurance still holds for starting weight? COOL!

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Exactly. I went through the 6 month diet and was approved (with United Healthcare) and I ended up losing 40 pounds and the BMI I had after the 40 pound weight loss was less than 40 (around 37) and I didnt have any comorbidities. They really just want to see if you are capable of following directions and making a commitment (following the diet and losing weight). So you are definitely on the right track. Please keep us posted and congrats!☺

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[Tara1992 79]

My starting weight was below 40 by .3 and then I was at 37 bmi two months later and I was just approved for surgery. Seems that if you are compliant and following all procedures, then insurance will approve you. My Dr. was nervous that I would be declined due to bmi but he said he would most likely just talk to the insurance on the phone and they would approve it.

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[tholbert08 51]

I have a letter from my PCP of 20+ years supporting my having the weight loss surgery so hoping that works in my favor too.

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[audaciousmarie 165]

My starting weight was below 40 by .3 and then I was at 37 bmi two months later and I was just approved for surgery. Seems that if you are compliant and following all procedures, then insurance will approve you. My Dr. was nervous that I would be declined due to bmi but he said he would most likely just talk to the insurance on the phone and they would approve it.

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You are one of the lucky ones to have had a great doctor who was on your side:) Some programs are so strict about the at least 40 bmi if no comorbidities.

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[Tara1992 79]

My starting weight was below 40 by .3 and then I was at 37 bmi two months later and I was just approved for surgery. Seems that if you are compliant and following all procedures, then insurance will approve you. My Dr. was nervous that I would be declined due to bmi but he said he would most likely just talk to the insurance on the phone and they would approve it.

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You are one of the lucky ones to have had a great doctor who was on your side:) Some programs are so strict about the at least 40 bmi if no comorbidities.

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I do think my doctor is great. I cried in his office the first consult because talking about my weight is really hard for me and he comforted me and reassured me I'd be healthy again.

Also, I do have PCOS, 4 herniated discs, and I was pre- diabetic at the time of my blood work. I think by the time I got around to dealing with my weigh and getting sleeved, my insurance was like "yeah sure, if it'll stop her from going to all these other doctors all the time."

Hahaha but I did get a little lucky! I was extremely nervous of getting denied.

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[tholbert08 51]

My starting weight was below 40 by .3 and then I was at 37 bmi two months later and I was just approved for surgery. Seems that if you are compliant and following all procedures, then insurance will approve you. My Dr. was nervous that I would be declined due to bmi but he said he would most likely just talk to the insurance on the phone and they would approve it.

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You are one of the lucky ones to have had a great doctor who was on your side:) Some programs are so strict about the at least 40 bmi if no comorbidities.

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I do think my doctor is great. I cried in his office the first consult because talking about my weight is really hard for me and he comforted me and reassured me I'd be healthy again.

Also, I do have PCOS, 4 herniated discs, and I was pre- diabetic at the time of my blood work. I think by the time I got around to dealing with my weigh and getting sleeved, my insurance was like "yeah sure, if it'll stop her from going to all these other doctors all the time."

Hahaha but I did get a little lucky! I was extremely nervous of getting denied.

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So how far out are you and what is a critical word of advice you could give?

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[audaciousmarie 165]

My starting weight was below 40 by .3 and then I was at 37 bmi two months later and I was just approved for surgery. Seems that if you are compliant and following all procedures, then insurance will approve you. My Dr. was nervous that I would be declined due to bmi but he said he would most likely just talk to the insurance on the phone and they would approve it.

Sent from my SM-G900T using the BariatricPal App

You are one of the lucky ones to have had a great doctor who was on your side:) Some programs are so strict about the at least 40 bmi if no comorbidities.

Sent from my SM-G925T using the BariatricPal App

I do think my doctor is great. I cried in his office the first consult because talking about my weight is really hard for me and he comforted me and reassured me I'd be healthy again.

Also, I do have PCOS, 4 herniated discs, and I was pre- diabetic at the time of my blood work. I think by the time I got around to dealing with my weigh and getting sleeved, my insurance was like "yeah sure, if it'll stop her from going to all these other doctors all the time."

Hahaha but I did get a little lucky! I was extremely nervous of getting denied.

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Good for you for taking charge of your health despite your health challenges. It is so funny how insurance makes us jump through all of these hoops to get surgery but if they just looked a little closer and realized all of the money they would save in prescriptions, doctor visits, testing, etc if we could just get the surgery lol..but I digress.

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[Tara1992 79]

My starting weight was below 40 by .3 and then I was at 37 bmi two months later and I was just approved for surgery. Seems that if you are compliant and following all procedures, then insurance will approve you. My Dr. was nervous that I would be declined due to bmi but he said he would most likely just talk to the insurance on the phone and they would approve it.

Sent from my SM-G900T using the BariatricPal App

You are one of the lucky ones to have had a great doctor who was on your side:) Some programs are so strict about the at least 40 bmi if no comorbidities.

Sent from my SM-G925T using the BariatricPal App

I do think my doctor is great. I cried in his office the first consult because talking about my weight is really hard for me and he comforted me and reassured me I'd be healthy again.

Also, I do have PCOS, 4 herniated discs, and I was pre- diabetic at the time of my blood work. I think by the time I got around to dealing with my weigh and getting sleeved, my insurance was like "yeah sure, if it'll stop her from going to all these other doctors all the time."

Hahaha but I did get a little lucky! I was extremely nervous of getting denied.

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So how far out are you and what is a critical word of advice you could give?

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I am actually going to my doctor tomorrow to get my surgery date. The far a word of advice would be to FOLLOW YOUR DOCTORS RULES. I am very compliant and didn't miss one month / one appointment for my pre surgery requirements.

At times it is really hard, but I truly believe the pre surgery requirements will help me know better how to treat my body post op.

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[audaciousmarie 165]

My starting weight was below 40 by .3 and then I was at 37 bmi two months later and I was just approved for surgery. Seems that if you are compliant and following all procedures, then insurance will approve you. My Dr. was nervous that I would be declined due to bmi but he said he would most likely just talk to the insurance on the phone and they would approve it.

Sent from my SM-G900T using the BariatricPal App

You are one of the lucky ones to have had a great doctor who was on your side:) Some programs are so strict about the at least 40 bmi if no comorbidities.

Sent from my SM-G925T using the BariatricPal App

I do think my doctor is great. I cried in his office the first consult because talking about my weight is really hard for me and he comforted me and reassured me I'd be healthy again.

Also, I do have PCOS, 4 herniated discs, and I was pre- diabetic at the time of my blood work. I think by the time I got around to dealing with my weigh and getting sleeved, my insurance was like "yeah sure, if it'll stop her from going to all these other doctors all the time."

Hahaha but I did get a little lucky! I was extremely nervous of getting denied.

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So how far out are you and what is a critical word of advice you could give?

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I didn't go through with the surgery at that point. I just wasnt mentally prepared. However, 3 years later, I am back at it trying to get a surgery date with a different insurance. This time I am going through Kaiser. Even though I have not had the surgery yet I can still offer a piece of advice: Be absolutely sure this is exactly what you want and that you are really ready for this permanent change. Three years ago I thought I was ready until I was sitting in a hospital waiting room with my overnight bag, crying my eyes out because I was so scared. It took me 3 years to realize that I am truly ready for this change in a way I was not before.

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[Tara1992 79]

I totally agree @@audaciousmarie they're All about the $$$ but they lose $ with people like me! Lol. Wow just read your story, I'm so happy for you. There is nothing wrong with coming to terms that you weren't ready. Now you are ready and seem determined! Best of luck, do you know when your surgery will be yet?

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[audaciousmarie 165]

I totally agree @@audaciousmarie they're All about the $$$ but they lose $ with people like me! Lol. Wow just read your story, I'm so happy for you. There is nothing wrong with coming to terms that you weren't ready. Now you are ready and seem determined! Best of luck, do you know when your surgery will be yet?

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Thanks so much! I definitely hope that my story lets others around me know they are not alone in this battle. Kaiser is a little bit different so I havent received a date yet. I just need to lose about 10 more pounds and then I will get my date.

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