Pre-op Question

[nancyginnm 5]

Hi, I hope this isn't a dumb question. What is the purpose of the requied 3 or 6 month waiting period (insurance required)? I don't have my initial consult until 4/5. Thanks!

[Kristi Twisti 18]

The insurance companies will say it is to make sure you can stay with a program long term. I had a surgeon say that it is just so the insurance companies can delay paying for the surgery. Apparently it's all about the statistics that by the time payment is due, you will hopefully have different insurance so they don't have to pay.

If it were based on anything to do with your health, then I would think there would be more of a consistency between companies and requirements. The surgeons don't require it so I think it's just a bunch of baloney really.

Maybe someone else will have a more positive answer for you. lol

[peacequeen 434]

Me, my husband and the HR lady at my husband's employer spoke with total of 6 different people with UHC (choiceplus plan) and they stated I DO NOT have to go on a 6 month pre op diet. When I went to my consult the insurance coordinator insists that I have to go on one per my insurance company. She said people like to argue with her about it and that almost all insurance companies require this (that's bs). So then I'm sent into to talk to the nutritionist and she gives me a notebook with a "HUGE" diet to follow for the next 6 months. But then she tells me not to lose too much weight?? This really doesn't make sense to me at all. She said she was required to tell me about this diet and to tell me to follow it because it will prove to my insurance company that I am serious. I've kinda laid low with the whole plan. It's so far out of reach for me right now, I can't even get excited or motivated at this point.

[Rainydayz 3]

I agree its a bunch of bs. Just a way for the insurance companies to keep their expenditures down. I'm sure they have some actuary reports that say anyone who can stick with a plan for a few months is more likely to be successful with the band and thus cost the insurance company less down the road. But in reality I think it's to weed out more people who might decide that if they lose weight on their own they won't get the band after all. But seriously how many of those people keep it off? The insurance doesn't care, by the time you gain it back they hope you're on another insurance plan. Anyway, it's just a hoop that we have to jump through. I'm just trying to make the best of it.

[ElizabethNYC 1]

Hi, I hope this isn't a dumb question. What is the purpose of the requied 3 or 6 month waiting period (insurance required)? I don't have my initial consult until 4/5. Thanks!

To make people like me crazy and yell at Insurance company's on the phone! :-P jk (sorta)

I agree, I think it's BS as well.

[rottie69 4]

I had to do a 6 month doc supervised diet plan.

At the same time, the hospital I dealt with for my WLS told me it would be approx 6 to 8 months before the whole process was finished. SO, heres how it went for me. This started in September 2008.

1st month September, referral from my doc (which was considered my first diet visit), orientation class at the hospital, and 1 support group meeting.

2nd month October, nutrition class. Doc diet weigh in.

3rd month Novemeber, 1 on 1 with a nutritionist. Doc diet weigh in.

4th month December, Phsych eval. Doc diet weigh in.

5th month January, Doc diet weigh in.

6th month February, SURGEON visit and approval request sent.

2 weeks later, denial letter was received. INsurance said I didnt have2 years of DOCUMENTED BMI of 40 or above. Hmmmmm what now?

I stopped appealing,,and started working out and lost 10 pounds.

August 2009 arrived and I said to myself,,,,,Self, call and see if Cigna has changed any of their requirements for WLS. YAY they had. In june 2009 they changed it to read you only needed 12 months of history stating you were over the BMI of 40. So back I went,,,I didnt need to see anyone , the surgeons office sent the original paperwork in again and my insurance approved it! I had my surgery septmber 16th of 2009,,,not even 4 weeks after I made the call to see if the changes had been made!

Hang in there it does take some time for some of us. But I found that it was worth it and i was more prepared for it than if I had just run and got the surgery in a matter of weeks. There is alot to learn.

Take care and good luck !