Losing too much weight before surgery cause insurance to cancel?

[DougNichols 124]

Hey guys!

If I really apply myself, I can lose weight fairly quickly. So I'm concerned that once I go on this mandatory insurance-hoop 4-month diet plan that I'll drop quite a few pounds (which is a good thing, only problem is that I'll gain it back).

So if I lose enough weight, will insurance say "just keep doing that, you don't need the surgery - DENIED" ??

I'm wondering if I need to regulate the weight loss, and not lose a ton during that time period.

thanks

[laylasmojo 10]

I am kinda in the same boat as you but not really. I did not have to do a mandatory supervised diet, but the doc and nut like me to start one just to start to get used to the idea of eating smaller portions and better choices. So any way I started off a a 41 BMIand my ins does not cover you if you go below 40 I was told by my doc to actually stop loosing weight untill I am aproved just in case the ins asks what my current weight is (although with the help of the wonderfull people on here have decided not to stop loosing but to just put ankle weights on or drink alot of H2O before my next apt :thumbup:) So I guess my actuall answer is dont go below the BMI that your insurance covers and call you ins company or doc and see what thay say they are looking for with the supervised weight loss.You may just have to not be so "complient" with the diet. Good luck and keep us updated .

[DougNichols 124]

LOL ankle weights? That's pure win. So I can lose all I want, just wear a little something extra to my appointments.

Thanks!

[laylasmojo 10]

If you feel confortable with it and you think you can get away with it I say GO FOT IT the more you loose the better you feel!!!

[lunarose 97]

Hi, I know at Kaiser they want you to lose about 10% of your weight while going through their hoops if you dip below their magic 40 BMI because you lost that 10% they say they will not cancel you.

[Was a humpty dumpty 35]

These insurance companies really know how to mess with people. I read one post were

a nurse said even if you are 1 pound from the 10% (under) the Surgeon won't see you.

[DougNichols 124]

10% sounds very reasonable. For me, that's 1 lb per 4 days. So long as they don't drop coverage for the surgery because of the weight loss, I'll be good.

thanks for the input!

[MaceoMack 0]

I am currently involved with the Kaiser Permanente "Options" program in Southern California. At the beginning of the course, participants were encouraged to loose as much weight as possible prior to surgery, the goal being 10% of your starting weight.

** I WAS INFORMED BY KAISER THAT ANY WEIGHT LOSS PRIOR TO WOULD NOT AFFECT THE SURGICAL SCHEDULE..

I am in week 7 of the 12 week program, and have lost 20 pounds through the pre surgery diet program, which would leave me with another 10 pounds to go to hit my 10%.Even with a successful pre surgery weight loss, there is no guarantee that the weight loss could be sustained, and in all likely hood, some or all of the weight would eventually return.

The surgery is considered a "tool" to help with the continuation of the weight loss process on a permanent basis

Edited August 21, 2010 by Mr_Mason

[LeonidStar 0]

I just asked that same question to my Patient Coordinator yesterday. I'm just getting started and I have to complete a 6-month diet & nutrition program per my insurance requirements. I was told that the BMI my insurance goes by is my starting BMI...not what I will weigh in 6 months after dieting. I, too, can lose weight like gangbusters. I just can't keep it off. Of course, YMMV so you will have to check with your specific insurance provider.

[Cancel 1]

I think they use your start weight as the determining factor. I lost a few pounds on my 6 month diet plan but they submitted my weight from the first visit as my weight.

[ngory07 22]

I have BC/BS IL and they put in their clause that they count your starting weight as the BMI requirement. So if you started at 310 and get down to 250 they will approve you because you were 310. I had the same fear b/c I also heard about this on here.

[laylasmojo 10]

hello Just an update to an eairler post that I did.... So I went to the Dr.and since I had lost the 11 pounds which put me under the required 40 BMI ( This will be the weight that the dr sends to the insurance company) I put ankle weights on both legs put my house and work keys, phone, and box cutter in my pockets ate Breakfast and drank a liter of Water before I steped on the scale And I made it YEAH ... I was a 40.1 BMI LOL I never thought I would be trying so hard to make the scale go up :confused1: