Denied by insurance for not losing enough during 6 mo. diet?

phthaloblue · March 8, 2009

I'm curious if anyone here has gone through a doctor-supervised, insurance-required 6 month diet and been denied coverage due to not losing enough weight.

I'm asking because I've been doing the 6 month diet for about 4 1/2 months now, and have completed every other requirement my insurance company needs. A really nice employee at the insurance co. mailed me the criteria including fine print regarding each requirement. The fine print for the "6 month doctor supervised diet" mentions ideally losing 5-10% body weight.

I see my nutritionist monthly, and we haven't really been focusing on losing weight, just trying to fix some bad eating habits and learn new, better ones. So while I'm proud of myself for maintaining my weight for the first time in my life, there's a chance that it will get me denied. I'm buckling down and trying to lose as much as I can in the next 5 weeks, but what if I can't lose the 5%? (12 lbs for me)

AudsMom · March 8, 2009

Up your Water intake and lower your calorie intake and you will loose that plus more in the 5 weeks. The first 10 lbs is all Water weight.. and it is pretty easy to loose, its after you get to the 10% when it gets very very hard..

Good Luck i am sure you can do it!

edub · March 8, 2009

Would you be denied if you DO NOT lose weight or if you DO lose weight?

I would think the purpose of the 6 month diet is to see if you can control your weight without surgery and therefore not need it. I could see the insurance company making this argument. I could be wrong though.

malissa · March 8, 2009

I too gained on the 6mo diet.

However, Humana still approved me...

ait · March 8, 2009

I didn't lose weight on my 6 month diet. I did lose some the first month but gained it back the next month and then fluctuated up and down by 2-3 pounds for the next four months, ending exactly where I started. I was approved by Aetna in one day. I'm sure you'll be fine.