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Just wondering if anyone knows if the 6 or 12 month diet plan would be waived if my Dr determined it is medically necessary for the surgery. I found out I have a brain disease that puts me at high risk of stroke. I’m worried my insurance Blue Shield of California won’t approve it without me doing some sort of failed diet plan first otherwise I’ve completed everything else and am just waiting on approval

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I wasn't put on a diet plan. I just had to have 6 monthly visits with the nutritionist. My surgeon wanted me to lose 10-12 pounds before surgery, but my insurance didn't. However, I was not allowed to gain weight.

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that's a question only your insurance company can answer...

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Ordinarily, no, it's hard to get the companies to waive that - it's one of the roadblocks that they like to use to encourage patients to go on their own and self pay, so they don't have to pay for it - but if there is a viable medical reason for skipping it, then it's a matter for the surgeon to convince the insurance company of it. Usually, that takes about as long as doing the 6 month diet, so one should plan on it and get started, and just hope that maybe they can shorten things a bit.

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I am waiting on my approval and my primary physician had to fill out a form the last five years of weight history and also medical history

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On 1/24/2023 at 10:43 PM, Charisse Jordan said:

Just wondering if anyone knows if the 6 or 12 month diet plan would be waived if my Dr determined it is medically necessary for the surgery. I found out I have a brain disease that puts me at high risk of stroke. I’m worried my insurance Blue Shield of California won’t approve it without me doing some sort of failed diet plan first otherwise I’ve completed everything else and am just waiting on approval

As someone else said, only your insurance can answer that. However, with a neurological issue, your surgeon may require neurological clearance for surgery. That's what happened to me. I have seizures and while I had every other criteria met, my surgeon required neuro clearance (my insurance didn't).

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