6 Month Supervised Diet?

[JonathanS 75]

Hey Sleever's,

I have been lurking for awhile and just researching the procedure. I had the talk with my PCP today about VSG and he actually preformed bariatric surgery back in the '80s. He was telling me how different it was back then to today. However, something came up in my blood work that I need to see a specialist about (hormone levels) and wanted me to do so before the surgery.

Then I got the call from Dr. Black's (surgeon) office on my insurance for the surgery. I have the normal requirements:

- 6 month supervised diet

- Psych Eval

- Nutritionist

My main concern was the cost. My insurance (Blue Cross of California) lists it under General Surgery so it is a 30% copay. I have a $1500 deductible. They said the total cost would be $2,000. Talk about a relief!

So my question is, what exactly is a supervised diet? My PCP didn't talk much about it and was more concerned about getting my hormone levels under control. Just trying to get an idea of what I should expect. 6 months seems like forever, but 24 years of obesity has been much longer!

Cheers!

[Liliana Arleen 173]

The 6 month supervised diet is basically a weight loss diet program supervise by any Dr,dietician or weight loss program such as weight watchers,jenny craig etc.

I don't know how is in your bariatric clinic but at my bariatric clinic they do offer some nutrition classes in less than 6 months and those count as the 6 month supervised diet.

Maybe you want to ask if they offer any program like that at your bariatric clinic. Good luck with process

[Delta_35 129]

Hello!

Well I have Aetna and you can either do the 3 month or 6 month supervised diet. I decided to do the longer track just because I was not sure about surgery. What I did was setup an appointment and took the clinical bulletin with me which outlined the requirements. I told my doctor that I wanted to be put on nutrition plan and an exercise regimen. I am not sure what your insurance exactly states, but mines just said nutrition plan supervised by my doctor. So, my doctor put me on a nutrition plan and directed me to work out 3 times a week. She also weighed me. All of this was documented in her notes, and every month for 6 months I would come in, get weighed, discuss my exercise plan and food intake. That’s all I did and I was approved this morning!

Just an fyi that you may have to do more requirements to prepare for surgery, such as have an abdomen sonogram, chest xray, ekg, etc, which was all required by my surgeon for clearance!

Hope this helps, and good luck!!!

[JonathanS 75]

Maybe it is just me but this copay amount almost seems to good to be true. How can 30% of the procedure be $500? That puts the procedure at $1700.00. I even called them back to make sure I heard her right. She confirmed and said that it could be even less if I meet more of my deductible. Maybe I just don't understand my insurance.

[Liberated Sleeve 148]

Maybe it is just me but this copay amount almost seems to good to be true. How can 30% of the procedure be $500? That puts the procedure at $1700.00. I even called them back to make sure I heard her right. She confirmed and said that it could be even less if I meet more of my deductible. Maybe I just don't understand my insurance.

Check your insurance and see if you have a maximum out of pocket amount per year - I am betting it is $2000 per individual?

[JonathanS 75]

Check your insurance and see if you have a maximum out of pocket amount per year - I am betting it is $2000 per individual?

I looked up my max copayment and it is $4,500/year. I also looked up Bariatric surgery and it is listed at $500/year + 30%. I wonder if she missed the 30%?

[Liberated Sleeve 148]

I looked up my max copayment and it is $4,500/year. I also looked up Bariatric surgery and it is listed at $500/year + 30%. I wonder if she missed the 30%?

She could have.

But, normally they send a pre-authorization to the insurance company and they send them back the coverage limits. You might call her back and ask her to read you what it says because if they did make a mistake and then surgery day comes and they realize it they will want the rest of the money and if you aren't prepared then bummer you will have to reschedule. Best to know now so you can plan!

[JonathanS 75]

I got the "skinny" on it. That was surgeon fee's only. I had to call the hospital.

So the break down is:

- $1,500 Deductible

- $3,000 Hospital

- $500 Surgeon

-------------------------

$5000.00

That sounds more like what I was expecting.

I wish she would have mentioned that in the original call.

[Liberated Sleeve 148]

Well at least you know the maximum out of pocket should be $4500

And talk with the hospital, most of them will do a payment plan for you. Mine was $1100 and they let me put $100 down and $100 a month for the next 10 months.

[BeatrizS1974<3 sleeve 94]

I am currently doing the supervised diet thing but i am not allowed to loose weight because they dont want me to fall to far under the BMI. Im currently at a 39.6 but have a comorbility (High Blood Pressure) Unfortunately my insurance carriers changed and we are still waiting on whether i have to complete the 6 months or if i can do it the 3 months.

What we do at the nutritionist is:

1st visit She weighed me and then ihad to fill out her intake. She looked over it and basically told me that for the first month she wanted me to cut out sugary drinks, and drink more Water. (30 minute visit)

2nd visit. She explained to me what i could eat after surgery and pre-op and explained that i had to eat slow and a bunch of stuff i already learned from the vets here. my task for this month was to eat slower and to chew everything at least 30 times. (the chewing things 30 times makes me want to gag) (1 hour visit)

If all goes well my may visit may be my 3rd and last visit with her and they can submit all my paperwork.

As far as insurance goes my deductable is $300 and they will cover 100% of my surgery and anesthesiologist which im very thankful for cause i dont have the money to pay for it out of pocket. The only thing is that they still have not decided whether i will do the 3 month or 6 months with the NUT.

[JonathanS 75]

Beatriz,

Did your surgeons office recommend the nutritionist? I was told that around month 5 that they would work with me on the nutritionist and psych eval. I'm wondering if I should go ahead and see a nutritionist from my supervised diet or my PCP.

Thanks everyone for the great feedback!

[BeatrizS1974<3 sleeve 94]

My NUT is an in office one. She works in the practice and they set everything up for me. If i were in your position i would call the surgeon and ask them who they recommend, who knows they may have one they work directly with. They may have someone that they work with directly. They also referred me to their own Psychologist.

The great thing is since they are both in the same office they work things out and instead of having to see both every month i alternate them. One month Surgeon, one month NUT. The months i don't see the NUT she calls me and we do our visit on the phone. Hope that helps.

Beatriz,

Did your surgeons office recommend the nutritionist? I was told that around month 5 that they would work with me on the nutritionist and psych eval. I'm wondering if I should go ahead and see a nutritionist from my supervised diet or my PCP.

Thanks everyone for the great feedback!

[aviiva 140]

I have atena

[aviiva 140]

I have atena insurance and they paid half it cost me 13000 out of pocket the hospital.was.11000 I do not live in beverly hills I live in louisville ky. I don't regret doing it I will think about all that money when I want to cheat