kaneohegirl 2 Posted March 2, 2011 Does anyone know of a way to avoid the 6 month diet requirement that insurance requires?... yes Im impatient I just want to get this done. Currently I dont have a job and if this were done NOW while out of work I could then not worry about needing time off or have to wait till possibly NEXT year to do this.(because some employers wont give you time off for the first year) I have been treated by the same DR for over 5 yrs... he has watched my weight gain and has been on me to loose and has given me diets to go on but since I dont have 6 consequtive months Im SOL.... I dont wanna be SOL... Any ideas? Share this post Link to post Share on other sites
StacyS 20 Posted March 2, 2011 In all honesty, I dont think there is a way around it. I have BCBS-Fed and they required a 3 month diet. I was all excited since I had done a doctor's supervised diet with pills and B12 shots from 8/09-3/10 and when I submitted my paperwork for approval they said that they wanted the diet 3 months 'prior' to the request for surgery... AND they wanted it with the surgeon's nutritionist, not an independant "diet doctor". So, to my dismay, I had to start the dreaded 3 month process!! Luckily I will be having my 2nd appt for the second month next week and then in April my last appt. Once my appt is over in April, paperwork will be sent that day to insurance and hopefully surgery in late April or early May. It really does suck to have to wait, especially since we want it NOW.... but in this 3 month time frame, I have really done a lot of research and have gotten really educated about the sleeve and went from wanting the band to KNOWING I want the sleeve!!! So, use this time to get really familiar with your eating habits, make the appropriate lifestyle changes now, and focus on learning as much as you can!! The time will fly by... You'll See!!!! Share this post Link to post Share on other sites
MRSKOUBiK 27 Posted March 2, 2011 There's no way around it. it's REQUIRED. Otherwise if they see you dont have it, they'll deny you. I think they use it to test your commitment Share this post Link to post Share on other sites
Rootman 1,101 Posted March 3, 2011 The self pay option is probably the only way to avoid the extended required diet. MOST surgeons require a pre-op liquid diet, time varies from a few days to 2 weeks. Share this post Link to post Share on other sites
kaneohegirl 2 Posted March 4, 2011 yea the liquid diet wont bother me... its this waiting and waiting that bothers me... I had hoped to push it thru and get it done WHILE I was unemployed SO I now have 2 months documented since I had seen the dr in Feb and when I took the papers in for him to look at he filled it out starting feb and did march since it was march 1 so technically 4 months togo... but then after that... I might have to wait even longer since I am looking for employment and HOPEFULLY will have a job by the end of the month. if so it will be a while till I can get time off for the procedure. **BIG HUFFY SIGH** Share this post Link to post Share on other sites
ccbcdeke 11 Posted March 7, 2011 I have heard the phrase "6 months in the last 2 years". I would ask the insurance if they can accept it even if you don't have six consecutive months since it sounds like you have five years worth off and on. just a thought. Share this post Link to post Share on other sites
Stacy160 201 Posted March 7, 2011 From what I understand, it has to be six consecutive months, and they'll look for any reason to deny you, so you have to be REALLY diligent about going in to the doctor and having them document your weight six months in a row. Personally, I'd go every four weeks on the nose, for 7 visits, just to make sure there's no loophole for them, at least as far as that goes. Share this post Link to post Share on other sites
doggz109 41 Posted March 14, 2011 yea the liquid diet wont bother me... its this waiting and waiting that bothers me... I had hoped to push it thru and get it done WHILE I was unemployed SO I now have 2 months documented since I had seen the dr in Feb and when I took the papers in for him to look at he filled it out starting feb and did march since it was march 1 so technically 4 months togo... but then after that... I might have to wait even longer since I am looking for employment and HOPEFULLY will have a job by the end of the month. if so it will be a while till I can get time off for the procedure. **BIG HUFFY SIGH** I thought if you had a procedure that was considered "medically necessary" that an employer could not deny you time off to do it? Obviously you won't get paid...but I didn't think they could deny you time to get a surgery done that is life saving. What would they do if you were in a car accident and needed 2 months off for recovery? Share this post Link to post Share on other sites
KinkySlinky 3 Posted March 15, 2011 I believe that you are allowed up to 12 weeks of time off for medical/family issues under FMLA (Family Medical Leave Act). Unfortunately, there are certain qualifications that you and/or the employer have to meet before you qualify for a job-protected leave of absence. Also, there isn't a way around the 6 month pre-op diet requirement... Sorry!!! Share this post Link to post Share on other sites
Rekeca 0 Posted March 24, 2011 From what I have been told fromsurg my eons office is, if you have already seen your MD for 6 consecutive months fore weight management anytime within the last two years then that can be used so that way you want have to start from scratch. Share this post Link to post Share on other sites
CamaroGal 3 Posted April 1, 2011 Double check with your insurance. My insurance did not require a 6 month diet plan. I did have on record my weight loss attempts with my GP. Share this post Link to post Share on other sites
kpodle 3 Posted April 3, 2011 I have BCBS administered by Health Comp. They require 6 months but my surgeon told me during my initial consult that he often submits after just 3 months and gets approvals. In my case, he submitted 8 weeks after our initial consult after having met with him 3x, the NUT 3x, and getting the pych eval. I was approved a week later and my surgery is Monday, April 4. Share this post Link to post Share on other sites
crosswind 134 Posted April 3, 2011 Does anyone know of a way to avoid the 6 month diet requirement that insurance requires?... yes Im impatient I just want to get this done. Currently I dont have a job and if this were done NOW while out of work I could then not worry about needing time off or have to wait till possibly NEXT year to do this.(because some employers wont give you time off for the first year) I have been treated by the same DR for over 5 yrs... he has watched my weight gain and has been on me to loose and has given me diets to go on but since I dont have 6 consequtive months Im SOL.... I dont wanna be SOL... Any ideas? Go to Dr. Aceves? He'll finance you. If your doc is amenable he can write any subsequent claims and checkups as routine for something else. In fact if all goes well and you go down there the Insurance Borg doesn't even have to know you're missing part of your stomach for a long, long time. Share this post Link to post Share on other sites
StacyS 20 Posted April 4, 2011 My 3 month appt is next Monday, 11 April 11 and then we submit to BCBS for approval.... the 3 months FLEW by, honestly!! Share this post Link to post Share on other sites
soul spirit 0 Posted April 8, 2011 Does anyone know of a way to avoid the 6 month diet requirement that insurance requires?... yes Im impatient I just want to get this done. Currently I dont have a job and if this were done NOW while out of work I could then not worry about needing time off or have to wait till possibly NEXT year to do this.(because some employers wont give you time off for the first year) I have been treated by the same DR for over 5 yrs... he has watched my weight gain and has been on me to loose and has given me diets to go on but since I dont have 6 consequtive months Im SOL.... I dont wanna be SOL... Any ideas? Theres no way around it I tried allready I have BCBS too and they just changed it to12 consecutive months . i registered in dec2010 and it was 3 months well to my surprise got all exams clearences done and to fined out that everthing was cancelled until until i finish my12 month supervied diet with doctor ....I was so upset , but called insurace and theres no loop holes just need to keep going for visits and month by month and not to miss one because they will deny me . so i figure oh well 3 months went fast whats 7 more . have faith will get there just keep seeing doc . Share this post Link to post Share on other sites