6 month weight management to be approved...how does this work?

[jordan1079 6]

Hi there! I'm new to this and just filled out all the paper work and just called my insurace company today (BCBS of MIch). Was told surgery is approved but have to have 6 months (consecutive) of weight management before I can do the surgery. Has anyone else had to do this? How does it work? What is the insurance looking for with this? Just to see that you've tried to do it yourself or what?

Haven't gone in for the initial Dr's visit yet. They called yesterday, now just waiting for them to return my phone call back so we can get the ball rolling!

[brandy88 151]

I did I seen my regular dr and did weight check and talked about diet. I had seven in total to do a full six months of diet. At end they agreed I should have surgery.

[jordan1079 6]

How much did you lose Brandy? Does the Dr give you something to follow or are you on your own?

[phenetra 26]

I saw a dietitian for 6mth, i weighed in once a month and she will go over important information about eating healthy. the lasted for an hour and you must attend the class 6mth straight without missing a month

[xcillax 24]

I'm going through this as we speak, but mine is a 3 month supervised diet. I have 2 1/2 months left. Good luck!

[ISleevedIt 380]

I have Kaiser insurance and had a 6 month program to go through. 2 group classes and 4 visits with the nutritionist. After that, the nutritionist submitted my paperwork to the committee for final approval. My understanding is that if you got approved in the program, then you just need to follow their guidelines for the 6 months. Oh, I did have to lose some weight also. It's a percentage of your weight. Good luck with the process.

[brandy88 151]

I didn't lose any in fact gained had a bad six Months, stress eater.

[BethAnn77 12]

I live in Northern MI and also have BCBS. I started my 6 mos in Nov and will surgery in May. I basically just went to my primary and we discussed diet and exercise. Then she sends a form detailing everything to my surgeon's office. Have you started your visits yet?

[sandra43230 9]

I am halfway through my six months. I do mine at my surgeons office. I go in once a month and weigh. My BMI is borderline. They are limiting the amount of weight that I can lose and still qualify. It's basiclaly just for documentation purposes.

[Debbie Neff 6]

Mine is exactly the same as Sandra. 6 months nut for 45 min or so, and dr. Supposed to be on 1200 calories, walking 5 days a week, but can only lose 10-12 lbs in the 6 mos. this is all to get the insurance approval. If I stuck exactly to 1200 cal every day and walked 5 days a week for 30 min, I would not need the surgery. I only have pre diabetes, no sleep apnea, or anything else and they don't want my BMI under 40. It seems like a game for the insurance company

[jordan1079 6]

Haven't started yet. I need to have the information from my insurance to pass on to the hospital. I called today to schedule my initial visit to get all the tests done etc. but didn't hear back from them. Do you follow an actual diet or is it just meeting with nutritionists and the doctor once every month to apease the insur. company??

[BethAnn77 12]

Haven't started yet. I need to have the information from my insurance to pass on to the hospital. I called today to schedule my initial visit to get all the tests done etc. but didn't hear back from them. Do you follow an actual diet or is it just meeting with nutritionists and the doctor once every month to apease the insur. company??

I think it might be a little different, depending on the doctor. My surgeon's office sent a form to my primary that had spaces for weight, blood pressure, pulse, what diet issues were discussed at the appointment, exercise, behavior and if I was prescribed medication to assist with weight loss. My primary fills this out after my appt every month and then sends it to the surgeon. But it might be different for other doctors. I am going through McLaren in Petoskey, MI with Dr. Randal Baker, who is based out of Spectrum in Grand Rapids. (I saw that you have BCBS of MI so I'm assuming you're from MI?)

[jordan1079 6]

No I'm from Ohio

[The Travel Guru 40]

I went to my surgeon back in August 2012 for a consultation, with my BMI being so high (44) he said I would not have a problem. His office staff set up all my appointments, my three month appt's with my NUT, and all other tests that you have to go thru. They printed out a sheet with all my appointments on it. A couple days later, they called and said I was approved for surgery. While visiting with my NUT, she was the one who told me what I should be eating and she also monitored my weight. I did not have a pre op diet (every dr is different). I only loss 4 pounds prior to surgery which I had on 1/2. And all went fantastic.. I could not be happier.. Good Luck in your journey, it will all be worth it in the end..

[Lorie269 392]

I am currently in month 2 of my 5 month program (UPMC insurance). I attend a seminar once a month where they discuss a nutritional or fitness module, they record my weight, and I submit a monthly food log. They would like to see a weight loss each month but I was told it is ok to remain stable. They do not want to see any gain. Towards the end of my program, I see a NUT for a one-on-one and have my Pych Consult. I should be done early June. Good luck with your journey.