I have Humana and have been told I have to have a six month diet plan with someone like a doctor, dietician, or weight watchers after I meet with my doctor on Friday. Any suggestions on which to use. I am leaning towards setting up appointments once a month with my primary doctor just because my co-pay will be the same as paying for weight watchers and I can't right that expense off and I can write off a doctor bill. Can anyone tell me what kind of a diet plan you have with your doctor or whomever you are using. I am still frustrated because I know I will lose weight over the next six months. Usually I can get the weight to fall off. The problem is I can never keep it off. I start getting to hungry, to many headaches, and feeling horrible to continue. One piece of pizza becomes two and then three and so on. I am still afraid I will get turned down eventually by Humana if they see me lose some 40 pounds or so over a six month period, when we all know I will gain it back eventually. Help!!!!!

Hey Jig,

I like you had to do the required 6 month diet plan. I used my primary Doc. I was like you I was so afraid I was going to lose too much weight and then inturn not get approved. I have to admit that I only followed the diet to an extent, thus only losing 10 lbs in that 6 months. I also have no problem losing it, is just keeping it off that is the challenge for me. I talked with the bariatric surgeons office and they informed me that it does not matter how much weight you lose, or if you lose any at all, one of the things the insurance companies are looking for whether or not you have kept your appointments and have gone every month like required. Hope this helps and good luck!

I also have to do a 6 month regimen. I have bcbs of Minnesota. I am down to month 5 and have only lost 7 pounds. I havent really put in effort to lose much because I know im going on a liquid diet by my surgeon so I will lose more then... I plan on cranking it up tho this month and lose a few more.

I don't think they will turn you down for losing 40 your BMI is too high to bring you down under the standard 40bmi I think. I would give the 6 months a valiant effort but I know what you mean that it will come back.. This time it wont tho because at the end of the 6 months you will be banded just think positive :biggrin:

i am also on a 6 months "diet", i have tufts. i am just getting started with the program. i am going to give the "diet" my beside and i hope the insurance realizes it and will approve me for the band.

hi jigboy, i too had humana. but,,,,the 6 mo. diet thing is just a doc. preferabblly your pc, typing a letter saying that u have tried in the last 6 months different diets but to no avail. tell him u tried, atkins, wt. watcher, tops, nutrisystem etc. or watever u tried and did loose a little but gained it back. all u need is a letter stating this from a doctor. humana approved me within a week. fill out ur paper work the wt. loss dr. sends you and your support letter 'thats what it is called from ur personal doc.' and all the paper work. you should not have a problem. you dont have to 'PROVE' you were on these diets. just give an approximate date of when u did try them. you do need to have a bmi of over 40 or a comorbitie such as diabetes, high blood pressure or be over a 100 pounds overwt. if i can help u more, my email addy is 'chubgirl2003@yahoo.com. humana has their own bariatric program now too

hi jigboy, i too had humana. but,,,,the 6 mo. diet thing is just a doc. preferabblly your pc, typing a letter saying that u have tried in the last 6 months different diets but to no avail. tell him u tried, atkins, wt. watcher, tops, nutrisystem etc. or watever u tried and did loose a little but gained it back. all u need is a letter stating this from a doctor. humana approved me within a week. fill out ur paper work the wt. loss dr. sends you and your support letter 'thats what it is called from ur personal doc.' and all the paper work. you should not have a problem. you dont have to 'PROVE' you were on these diets. just give an approximate date of when u did try them. you do need to have a bmi of over 40 or a comorbitie such as diabetes, high blood pressure or be over a 100 pounds overwt. if i can help u more, my email addy is 'chubgirl2003@yahoo.com. humana has their own bariatric program now too

Mine requires me to go to their office once a month get a wegiht and talk to them about nutrition and how im doing with it. take about 15-20 minutes.

My bariatric center is just having me come to monthly appointments with a dietician at the bariatric center. I have Medica and have three months of it to do. I have kinda sucked at it this month - lost 12 pounds the first week and then said, well, damn, that was enough for one month! Not the best attitude, unfortunately.

I too have Humana and have to do the 6 month doctor supervised diet, which I elected to do with my PCP, and she is just basically having me follow an diabetic exchange type diet. I also have to have a consulation monthly with a nurse from active health as part of my insurance requirements to get approval for the lap band surgery because active health is the one that handles the approvals for wls for them from what I was told. I am not 100 % certain though

I am with BCBS of Minnesota as well and have to do the six month diet. I have been doing a combo plan with monthly visits to my dietician and my PCP. My PCP says that the weight you weighed the day you start is the weight they will submit to insurance. It doesn't matter how much you lose, just that you are able to keep on track with the diet and don't miss any appointments. That is the most important - do not miss even one appointment or you have to start over! I have lost 21 pounds so far. I figure the more I lose now - the less I'll have to lose after being banded! :smile2:

Good Luck!!

Jigboy~ I have BCBS of Alabama and I am in month 4 of the 6 month diet. My doctor told me it doesnt matter how much weight you lose as long as you are still at a BMI of 40(or 35 with co-morbidities) at the time you submit paperwork for approval to the insurance company. I have only lost 12 lbs so far but I have not been putting in but about 50% effort. I plan to really start this month and see if I can get my weight down some before surgery. Good luck to you!

This all makes me feel a whole lot better. I wanted to just about die when I found out that I had to do this and then could still get turned down. I will be honest, one of the main reasons I haven't been dieting this year is I want the surgery. In April of last year I got down to 310 and then headed to Hilton Head. Me and the all you can eat crab legs had a field day and that ended the whole diet deal. By July I had made my call to get into a seminar but didn't get to go until late September. The whole process is real slow but is going to be so worth it. I really do want to go ahead and lose some weight because my knees never hurt me until I got up to my current weight. It will be nice to lose about 40 or 50 before the surgery anyway. Thanks for posting back to me.

I have Aetna, and they require the 6 month diet plan. My PCP is not strict, and I just have to "tell" him what I am doing. I writes it down, we discuss exercise an nutrition, and 'how" to maybe "lose" some weight. He gave me the choice. I am doing South Beach, which I did the first time. I lost 30 lbs, during that 6 month period, but put it all back on the minute I hit phase 2. I have since put back on a total of 40 lbs. So my "records" show that I can do it, but need the help. And with many co-morbs, this will help greatly.

I really do want to go ahead and lose some weight because my knees never hurt me until I got up to my current weight.

I want to share that I was pretty crippled at my high pre-band weight (a little under 350); I was using a cane almost all the time and even with it couldn't walk much.

After losing ~25lb I felt less pain, and now, with ~45lb lost, I'm much more active, can manage walking on uneven surfaces (like the beach), and can walk further without pain. So I imagine you'll feel a lot better with even a 10-15% loss.

Good luck with your surgery.

I also have to do the 6 months diet. I cannot even start until next month since the dietitian at my PCP's medical practice has set times during the month that she meets with everyone who is going through the program. I have to do this even though I have been doing JennyCraig for 5 months and working out with a personal trainer for 10 months. I think that Dr's and insurance companies just want to make sure that you have tried everything else. To be truthful I am not going to worry about losing weight. I am at a BMI of 40 and only have one minor co-morbisite so I am going to have to fight to get my insurance to cover so if I were to lose weight my BMI would go down. I am just hoping not to gain as I know this is no quick fix and I will still have to work at weight loss. I am taking the 6 month to get all my documentation for insuarnce together and to get all the pre-test done.

Well I had my appointment today with Dr Jeff Allen. It was nice to see hime since we palyed football together in high school. I did find out the my blood pressure was 150 over 100 which is not good at all. They said that they have heard two different stories with Humana. Some people have had to do the six month deal while others have not. Bottom line is, they are turning it in and seeing what Humana has to say. I am sure they will reject it and I will be seeing a doctor for sim months, but I can get all the other test done and continue to enjoy a large piece of pizza every once in a while.

Here is a link to a .pdf of Humana's Bariatric Surgery policy. It will tell you what the doc has to chart at each visit, etc. You do need to see a physician, not use Weight Watcher's or something.

http://apps.humana.com/tad/tad_new/returnContent.asp?mime=application/pdf&id=5425&issue=132

Edie