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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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