nallygirl

I had my consult with the surgeon this week and it went pretty well. I have to do the 6 month medically supervised diet and fitness plan for my insurance requirement. My surgeons office is charging me $300 for this! Is that normal to have to pay for the medically supervised diet? Couldn't I just do this through my PCP? They are also charging me for nutritional classes, a nutritionist consult and other things they say I need to complete. All together I think its around $550 I'll have to pay out of pocket. I kind of feel like I'm being nickle and dimed but since I've never done this before I was just curious if this normal. Has anyone else experienced this?

Hi danide! For me the only person who knows that I am starting this process is my mom...I had to tell someone for support! Since I have a 6 month medically supervised diet I have to go through for insurance I don't want to tell everyone now then find out 6 months from now that I can't get the surgery for whatever reason. My plan is to wait until I have everything in order and a confirmed surgery date before I tell anyone else. Even then I only plan on telling my closest friends. I'm sure eventually people will ask and I will have no problem telling them about it. You should be proud that you are taking a step to better your health. The people who love you will support you! Good luck!!

You all are amazing!! Thank you for the great information! The $300 is for the medically supervised diet through the surgeons office. There is a $100 fee for 2 nutrition classes. There is a $180 fee for meeting with their nutritionist. None of this would have been covered by my insurance anyway and like someone else pointed out 6 months of co-pays would be almost $300 if I went through my PCP. I guess I just need to call the sugeons office and find out if I have to pay all this up front or if they will let me do payments at least for the $300. Thank again for the info! I love these boards...so much great information! :thumbup:

Thanks! I was pretty sure I could do it under insurance and they were just trying to make it sound like I needed to do it through them. I'll have to check it out more. Good luck with your surgery!!!

Karma and Alisomniac - Thanks so much for the advice! Looks like I worried for nothing...my PCP didn't even ask me any questions other than who is your surgeon so I can send them a referral!! YAY! She said she knows several patients who have Lap Band and love it and she thinks it would be a great idea!! One hurdle down now I am just waiting on the referral to come in the mail so I can make the appt with the surgeon. Then I also have to do the 6 month medically sup diet. My PCP is sending me for a sleep study too since she thinks I have sleep apnea...which in a way is a good thing...just one more thing to add to the list for insurance! Hopefully the rest of the process goes smoothly!! Thanks for all the advice and reassurance!! :laugh:

Hi there! I've been researching WLS for a few months. I've attended a seminar for Lap Band, verified my insurance will cover it after the typical 6 month medically supervised diet and psych visit, I found a surgeon, discussed my decision with my family and have an appt with my PCP on Thursday morning to get the ball rolling. As I was talking to a friend about it tonight she asked me the one question I never asked myself..."What if your doctor says no...what if they tell you all you need is diet and exercise?" Now I'm freaking out and starting to panic!! Has anyone had this happen?? What DO I do if she tells me no?!! I have fought this battle for 15 years, my BMI is 41 at 33 years old. I am ready for the rest of my life to begin and I can't do it on my own anymore. I'm sure I'm not supposed to say this but I NEED this surgery!! What do I do at my appt?! How do I get this point across to my PCP?? What do I do if she tells me no?? Any advice is greatly appreciated!!

Thanks LRTAB and Amy!! Tinksmom - Well as far as the PCP approval goes, according to my insurance (Cigna) this process needs to be initiated by my PCP if I want insurance to cover the costs. All insurance would really tell me is that yes they cover it if I have a BMI of 40+, that I will need to go through a 6 month medically supervised diet program and that my PCP will be able to give me more information once she initiates the process. Something about she needs to call a number and have me prequalified. I'm sure it will be fun dealing with insurance throughout this process! :wink: I will feel much better tomorrow after the appointment once I get this whole ball rolling!! Thanks for the advice everyone!! :w00t:

Thanks so much for your response! My PCP has been my doctor for almost 8 years now so she should be very familiar with my weight issues. I'm probably over thinking the whole thing and won't have an issue at the appt but once that thought popped into my head I had a momentary freak out! The appt is tomorrow morning so I'll be keeping my fingers crossed til then! :w00t: