Scared To Be Denied Because Of Pre-Op Weightloss!

[simply.torri 28]

Has anyone been denied surgery (disapproval from insurance) simply because they were able to lose a good amount of weight during the 3/6/9 months that Insurance requires??

I am pretty nervous about that.

Neither my surgeon or the insurance company have a required amount that I need to lose before surgery. However, I am supposed to be changing my eating habits (which of course is necessary) but............... I will cry for two months if the insurance denies and says "I lost weight so much weight during the 6months, so therefore I can do it all on my own".

Any feedback is welcomed!

[scorpion509 107]

I am scared as you are so I talk to my NUT and asked if insurance can deny you base on weight loss. and she said usually they don't. but I think I read on this forum that someone was denied.

[Pinky Green 260]

The NUT at my doctor says that they go by the weight you were when you came in. She said they have even had a few that lost all but about 20 lbs and still had surgery. It isn't that we can't lose weight, it's that we can't keep it off. I've lost 50 lbs several times, they found me again -and brought their friends.

[Raven21 121]

Ask now! I talked to the coordinator and she checked with my surgeon. He said he will use the first weigh in (start of program) on the application.

[simply.torri 28]

Ask now! I talked to the coordinator and she checked with my surgeon. He said he will use the first weigh in (start of program) on the application.

Yea they told me they go by your starting weight. I was just concerned that since i am losing weight, they will say I dont need surgery because i obviously CAN lose it. I keep asking but they dont really have a solid answer :/

The NUT at my doctor says that they go by the weight you were when you came in. She said they have even had a few that lost all but about 20 lbs and still had surgery. It isn't that we can't lose weight, it's that we can't keep it off. I've lost 50 lbs several times, they found me again -and brought their friends.

Yea keeping it off is CERTAINLY the issue! lol. I have had some lbs come in with their friends also lol! They told me they go by starting weight, but i just dont want them to say "Oh, shes losing weight just fine without surgery, so DENIED!

[Goody2shoesmelissa 12]

My husband was denied THREE times and on the fourth they finally accepted! Squeaky wheel got the oil, never give up! Be determined and keep at it!

[Justine13 264]

Ha- I just finished my 6 months and have the opposite worry- I gained every single month. Doc isn't worried. I worry though. To me it's yet one more diet that I gained weight on. I did change some habits (no pop in the last month at all)- Drinking Water (never did) . My doc states that this is what they care about. Wish I was calm like her.... Tic toc tic toc

[SensationallySassyT 80]

I don't belive you have anything to worry about Torrs~ Unless you plan on dropping 70+ pounds in the next 5 months I wouldn't sweat it~ In addition like the other ladies stated Ask, especially your nutritionist~ Most physicians and NUT's recommend you to drop the weight during the pre-op stage simply because it makes for a more succesful less risky surgery~}

T~ :wub:

[Huntingnurse 510]

My Nut said that it's based on your initial weight..... can't say I didn't totally fall off the wagon and pad a few pounds (about 10) prior to my initial visit.. lol just saying.

[simply.torri 28]

I don't belive you have anything to worry about Torrs~ Unless you plan on dropping 70+ pounds in the next 5 months I wouldn't sweat it~ In addition like the other ladies stated Ask, especially your nutritionist~ Most physicians and NUT's recommend you to drop the weight during the pre-op stage simply because it makes for a more succesful less risky surgery~}

T~ :wub:

Ya my physician and NUT said its healthy for the surgery to drop some weight, but nobody could answer the 'will i disqualify' question lol. I definately don't think ill drop 70lbs lol. If i do then I will only have 30lbs left to get to goal and wont need the sleeve lmao! That would be funny. But no your right i guess it will all be ok and work out correctly!

Ha- I just finished my 6 months and have the opposite worry- I gained every single month. Doc isn't worried. I worry though. To me it's yet one more diet that I gained weight on. I did change some habits (no pop in the last month at all)- Drinking Water (never did) . My doc states that this is what they care about. Wish I was calm like her.... Tic toc tic toc

Yes they said the same, they just want to focus on my behavior and if it has changed!! The changes you made are good! Did you gain a lot? I think you will be approved. Gaining wait is the reason we need the procedure

[Justine13 264]

Yes I did- thank u body of mine. Yet my pA is not worried in the slightest. I want to call the insurance company and tell them to HURRY!

[ediebumpkin 9]

I am having my surgery on Sept. 6th. when I initially went to a dr. I went to a satelitte for the surgeon in the county I live in (about 75 + miles from hospital). I weighed 388 lbs. I was told to follow the South Beach Diet and that was the last time I was weighed in or saw a Dr. for 6 mos. I myself went and got the psych eval when I learned my ins. required one but by that time I was 4 mos in and also learned that I needed monthly weigh ins with my PCP. oops I continued dieting and called the surgeons office and was given an appt to see him. That day was 5 mos. after my initial weigh in and I had lost 80lbs. My ins comp. waived the 6 mos weigh ins since I had wrote down everything I had ate and proved that I could lose weight and follow a plan. t has been a month since that weigh in and I know I have lost another 8lbs. So keep positive and talk to your surgeon!