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6 Month medically supervised weight loss and weight gain. Scared of Denial from Insurance



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Hi everyone, I am new here and I have finally decided to go through with doing the Gastric Sleeve. My surgeon told me that my insurance requires a 6 month medically supervised weight loss with my primary care provider. I am scheduled March 24th for my surgery, but I have gained 8 pounds within the last two months of my supervised weight loss. The nurse told me try not to gain, and insurance can deny me if I do gain. I have tried to get answers from my insurance company, but nobody has been able to answer my question. I am located in New York, and my hospital plan is city of New York Blue Cross Blue Shield ppo. I am supposed to go on 2 week liquid diet on March 10th, and I believe I'll lose the weight I gained from that. I am just really nervous of denial, and was wondering if anyone has my insurance, or has been denied for weight gain on the supervised weight loss? Thanks!

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Just now, byefatbye said:

I just don't understand why some insurances makes it so dang hard when it's already a difficult decision to make for us. Don't gain weight!? We're doing this because we can't keep the weight off in the first place!!

Sent from my SM-G975U using BariatricPal mobile app

I know! I think it's so ridiculous.

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33 minutes ago, Sbean12 said:

Hi everyone, I am new here and I have finally decided to go through with doing the Gastric Sleeve. My surgeon told me that my insurance requires a 6 month medically supervised weight loss with my primary care provider. I am scheduled March 24th for my surgery, but I have gained 8 pounds within the last two months of my supervised weight loss. The nurse told me try not to gain, and insurance can deny me if I do gain. I have tried to get answers from my insurance company, but nobody has been able to answer my question. I am located in New York, and my hospital plan is city of New York Blue Cross Blue Shield ppo. I am supposed to go on 2 week liquid diet on March 10th, and I believe I'll lose the weight I gained from that. I am just really nervous of denial, and was wondering if anyone has my insurance, or has been denied for weight gain on the supervised weight loss? Thanks!

Have you had your last weigh in?

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They want me to see my primary care provider in early march, I am supposed to see him March 10th. Which is the day I start my liquid diet. I am not sure if I am able to drop the weight I've gained by then, so it has me on edge lol. Supposed to see my surgeon on Monday, I will see what he says about it.

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6 minutes ago, JustJazzy said:

They want me to see my primary care provider in early march, I am supposed to see him March 10th. Which is the day I start my liquid diet. I am not sure if I am able to drop the weight I've gained by then, so it has me on edge lol. Supposed to see my surgeon on Monday, I will see what he says about it.

Have you had your last weigh in?

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9 minutes ago, Sbean12 said:

all I can say is try to make some progress so you can lose some by the time you see the surgeon. good luck

Edited by JustJazzy

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1 minute ago, JustJazzy said:

all I can say is try to make some progress so you can lose some by the time you see the surgeon. good luck

Yes, that’s what I’m going to do. Thanks so much! :)

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1 minute ago, Sbean12 said:

Yes, that’s what I’m going to do. Thanks so much! :)

Maybe start practicing the pre op diet people drop pounds fast with that. It’s going to work out didn’t come this far to let 8lbs stop you! You got this !!!

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When I started my 3 supervised weight loss visits, my BMI was 34.9 and I gained weight at every visit, Which worked out well because 35 BMI is the minimum requirement. Long story short, I ended up getting approved by my insurance really quickly. I have BCBS AL PPO.

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So glad that you were able to get approved. It makes sense, my BMI is 43 I believe now. So that’s why I am a bit nervous. I just hope everything works out

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On 2/27/2021 at 6:34 PM, Sbean12 said:

They want me to see my primary care provider in early march, I am supposed to see him March 10th. Which is the day I start my liquid diet. I am not sure if I am able to drop the weight I've gained by then, so it has me on edge lol. Supposed to see my surgeon on Monday, I will see what he says about it.

I'm curious about what happened. Are you interested in sharing? I'm in a similar boat. I have one month left of dietician visits and I need to somehow take off the weight I've gained. It's daunting.

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1 hour ago, muala94 said:

I'm curious about what happened. Are you interested in sharing? I'm in a similar boat. I have one month left of dietician visits and I need to somehow take off the weight I've gained. It's daunting.

Hi!, yes I can share. Thank god, even with the weight gain I was approved. What insurance do you have? I have blue cross blue shield ppo. I wouldn’t be too worried, if you get all the other clearances. Good luck on your journey! Wish you all the best :)

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Yay! I have the same. Good to know. Thanks for circling back, wishing you all the best as well. ❤️

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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💪
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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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