Mija

Hello everyone! I am sooo very close to submitting my paperwork to my insurance company but i want to make sure i have somethign straight before i do. I have Optimum Choice which is a part of United Healthcare and part of my requirements for approval are to show 6 months of being on a weight loss plan (ie: Jenny Craig, Weight Watchers, seeing a nutrionist). It does not say that my doctor has to be monitoring my progress. I have been seeing a nutrionist for several months so i will be using her notes to submit when its time. Here is my question...does anyone know the format of how these notes should be? Are they supposed to be very formal? She basically just puts what my latest weight is, what ive been eating, exercising etc. I will be the first person she submits notes on for Lap Band and i want to make sure i dont prolong the process by submitting things that arent acceptable to the insurance company. When we called them to ask exactly how they wanted it they just said to send in her notes. But im scared when we do they will want it to be more detailed or something and then i will get denied. Any advice and comments are appreciated! thanks! Nikki

Great idea! I go to my surgeons office tomorrow to meet with their dietician for a required visit...maybe they can help. Thank you!

WOW THAT IS WONDEFUL NEWS!!! Apparently i have Optimum Choice with is a part of United Heathcare...dont know if that makes a difference or not. May i ask what were your determining factors to get the approval? Did you have to get a psychiatric evaluation? Congrats on your approval...you must be so thrilled right now!!!

Hello, Today i went to my primary care for the first time to discuss getting Lap Band. He suggested i call my insurance company and find out what they need to get approved. One was a psychiatric evaluation. Another was some sort of proof of dieting from like Weight Watchers or Jenny Craig (not the internet kinds) for 6 months. My question is, has anyone been able to get approved without 6 months of some type of paid program? I have been dieting and calorie counting but on my own because i dont have the money to join a program. Any help advis is appreciated. My stats are 5'4", 261 BMI 44.8. Doc is having get a physical and blood work in two weeks and mentined sleep apnea test but didnt give me the referral yet.

Why would they want you to lose weight before the surgery? Is it more dangerous if you are a certain weight? Also, if you lose 30 pounds, couldnt that push you out of the range for being qualified?

Thank you! I have Optimum Choice Preferred (United Healthcare). My BMI is at 44.8 and i was told by my insurance company that it is coverd with a BMI of 40+ w/o comobidities so i definitely fit that category...i am also more than a 100 pounds overweight. I am going to find a surgeon today for a consultation. I guess i will just take baby steps for now!

Thanks for the positive outlook and CONGRATS on your approval! My daughters Cheer Coach is a Licensed Dietician/Nutritionist and she has been working with me since last year. She hasnt been charging me though, she just wanted to help me with the issues i was having but she has created meal plans, weighed me, had me keep food journals ect...does anyone think that would be enough for insurance? Or does it have to be something that has been paid for?

Thanks for your input. Not what i had hoped for but hey, gotta take the good with the bad right!