jessicakeslosing

In order to qualify for a Lapband to Sleeve conversion per my insurance requirements (Blue Shield of California) I need 1) to undergo a medically supervised weight management program for at least 3 consecutive months and 2) Have a BMI of over 40 or a BMI of over 35 with a comorbidity. (I do not have a comorbidity that I know of) Now. I signed myself up for a medically supervised diet plan on November 30. I thought to myself, hey, the more I lose now, the less I will have to lose after my surgery (logical right?). Well within the 4 months I've been on this diet, I went from a BMI of about 43 to a BMI of 38. Do any of you have experience with this posing an issue to getting insurance to cover their surgery. Any feedback would be helpful :-)

I have failure of the band by weight loss less than 20% and complications of GERD and esophageal damage caused by the band. Getting the band taken out was already approved, it's the actual conversion that gets a little complicated. They are sending everything into insurance on April 30 🤞

I talked to my bariatric surgery coordinator and she said that they will go by start weight [emoji106] she said insurance can't fault you for losing weight when they are the ones telling you to be on a 3 month pre op diet (makes sense). She also told me that insurances are more lenient for conversion patients. I'm feeling much more at ease after she told me that.

So this is what I was thinking too.... bulky clothes and drink a ton of water beforehand BUT my next appointment (and last appointment) is with my new nutritionist before they send it in to insurance. I've been doing a diet (keto) under doctor's supervision but then my surgeon's nutritionist specifically said "I need to know that you can follow OUR lifestyle plan in order for me to sign off on you"... so then that makes me think that she needs to see that I can lose weight following her specific rules [emoji86][emoji86][emoji86] ughhhh. I'm in such a pickle. Do you think maybe if I call her and I am just transparent about it that she would be understanding of my situation? Or talk to the PA and ask them if they can send in one of my higher weights instead when sending in the approval packet? I'm not sure how morally sound it is to even ask them [emoji51] Honestly, I am desperate. This whole conversion surgery is something I've put so much time and effort into. It's been years in the making. I've changed my lifestyle because I know that it is just a tool... thinking that if I change my habits now that it will make it easier for me to adjust when I do have restriction again. It just sucks to know that that is not being taken into account

I am submitting to my insurance on April 30! Surgeon schedules 2-3 weeks out, so I am hoping to be a May lapband revised to sleever!