sr910 55 Posted August 2, 2012 After being somewhat "on the fence" and experiencing happy/scared feelings, I finally decided, 100%, that I wanted to move forward and get the sleeve! I'm very much in the beginning stages (have only attended the informational seminar and given a copy of my insurance card) but I spoke with my surgeon's insurance specialist and I heard the dreaded words... "you have to complete 6 months of supervised dieting." After failing with medifast, weight watchers, slim fast, etc., I really don't want 6 months of, well, failure! But I just selected a primary care doctor and haven't even seen a doc for 1.5 years so I'm guessing there's no way around it. Anyone else doing the 6 months of supervised dieting? What's it like? Anyone get around the 6 months of supervised dieting? What did your insurance require from you? Share this post Link to post Share on other sites
MK1986 78 Posted August 2, 2012 I am right along with you in the waiting game. I start seeing my PCP this month and don't know what expect. I don't think there is a way around this req. Share this post Link to post Share on other sites
SMP1126 76 Posted August 2, 2012 The only way around it that I know of is if you self-pay for the surgery. The 6 month diet is a requirement from your insurance company before they're willing to absorb the costs of the procedure. It varies among different insurers, mine for instance required 3 months of dieting. Consider yourself lucky in a way because some insurance companies still don't cover WLS at all! Sent from my iPhone using VST Share this post Link to post Share on other sites
Lulu1513 14 Posted August 2, 2012 Hi, I think you are going to Dr. Mueller right? I am going with him too. I also have to do the 6 month diet. My first appointment is next week with the dietician at his office. It totally sucks to have to wait so long but there is no way around it. Share this post Link to post Share on other sites
kaeannpark 9 Posted August 2, 2012 The 6 month diet with Laura; Murllers NUT is Very easy.... There are little restrictions she just wants to see you eating health and exercising regularly. It's not about the weight loss it's about being healthy I only lost 10 lbs on my 6 mo diet. The biggest thing with Laura is make sure you log your food.... The time will fly!!! Share this post Link to post Share on other sites
sr910 55 Posted August 2, 2012 OMG called insurance to see what the specifics of the 6-month diet are and they said I have NO bariatric coverage! Dr. Mueller's coordinator, Monique, said she'd get me set up with Laura but if I don't have any bariatric coverage, might as well stop now! Open enrollment with my employer is coming up in October. I'll just have to do my research at that time and see who to switch to. Lame sauce. Share this post Link to post Share on other sites
mufasas-mom 170 Posted August 2, 2012 so sorry to hear that - I called my insurance company prior to making any appointments as I didn't want to waste anyone's time. Least open enrollment is around the corner and hopefully your employer will pick up the bariatric option. again, sorry you are not covered at this time. Share this post Link to post Share on other sites
SMP1126 76 Posted August 2, 2012 Oh man, sorry to hear that. Hopefully one of your choices at open enrollment will cover bariatric surgery. One thing you could look into even with your current insurance is if they'll cover it if your doctor declares that it's medically necessary. In that case, they might have to. Many insurance companies don't cover it right off the bat because they still consider it cosmetic surgery. It might be worth it to give your insurance another call. Sent from my iPhone using VST Share this post Link to post Share on other sites
sr910 55 Posted August 2, 2012 With my BMI what it is (46 I think) I am def going to exhaust every option. I can also try to supplement my insurance w/ my husband's and see if that helps... Oh well. Might as well sit back and not worry about it too much. Share this post Link to post Share on other sites
ebonisekim 1,713 Posted August 3, 2012 I'm sorry to hear that .. I'm on the six month supervised diet I'm be in my third month this month ... Before I could go on w the requirements the coordinator at the surgeon office ask for the # on the back of my card to find out Share this post Link to post Share on other sites
Nikki613 120 Posted August 3, 2012 I would go ahead and do your 6 months diet if your new insurance will cover bariatric surgery. Mine as well start now! My insurance only required the supervised diet be completed in the last year. Share this post Link to post Share on other sites
chitowngirl 886 Posted August 3, 2012 Wow that sucks. However I would start the 6 month diet just incase your next insurance requires you to have the 6 month diet as that seems to be a pretty standard requirement. Good luck to you. Share this post Link to post Share on other sites
Izuri 428 Posted August 3, 2012 I think Nikki's got the right idea. Get jump started on the 6 month diet. Can you get covered under your husband's plan? Maybe his covers WLS. If not, in October you'll already be most of the way through your 6 month supervised diet and then if you need it, awesome, if you don't, at least you will have lost some weight and therefore lowered your surgical risk. I guess the only thing would be you wanna stay above 40 or something (I can't remember the exact number, you might wanna check a few insurance guidelines) unless you have comorbidities, otherwise they could deny you for a low BMI. Share this post Link to post Share on other sites
mufasas-mom 170 Posted August 3, 2012 You may want to double check on the jump starting the 6 month diet - as it may require your 6 month diet to have started with the NEW insurance. I re-read my bariatric coverage on my insurance and it sounds like that would count as pre-existing, as in it was being done under the OLD plan - the new plan would not cover. Insurance is very tricky - so possibly contacting someone in your HR department may be able to help you out. Or, if you know what insurance companies will be a part of the new open enrollment - you can contact them. Where I work, we don't change that much - we always offer BCBS or UHC - but the plans themselves do change each year. best of luck to you Share this post Link to post Share on other sites
sr910 55 Posted August 6, 2012 I'm guessing that my insurance not showing any bariatric coverage is because it's not just automatically on everyone's plan. Hopefully my surgeon saying it's medically necessary will get me the "ok" from the insurance. My surgeon's coordinator just emailed me a couple days ago to say they'll be calling to set up a nutritionist appt so I can start the 6 months. However... I planned on changing my insurance in January anyway, because I somehow selected a plan where my normal primary care physician isn't covered. No use in going through all the nutrition stuff with one surgeon if I'm going to have to switch and start over. I currently have coverage with Sharp, but will be changing to Scripps. On a positive note there, my friend who went through Scripps didn't have to do 6 months of sup. dieting... We'll see. I'll just continue to lurk here and learn as much as possible! Thanks everyone =) Share this post Link to post Share on other sites