6 month pre surgery questions

[dommie20 3]

Hi all. I started the process for the surgery in June. My insurance requires 6 months of weights- that puts me on track for a November surgery. The office I went to the coordinator said I shouldn't lose or gain more than about 7 pounds from now until the surgery. I'm a little concerned about this. I want to eat healthier and I don't necessarily lose weight easily but I'm worried about losing more than 7 pounds. I have about 150 pounds to lose and can't do that on my own so I definitely need the surgery. Will I be denied if I lose more than 7 pounds. Like let's say even 10. Shared Experiences welcome!!!!

[VSGFOX 1]

@@dommie20 I'm curious about this too. I also have to do the 6 month deal. I'm do for surgery in January. However, when I had my first appointment(July 7th) there was no mention about gaining or losing. I"ve heard people say they were denied for losing too much :-/

[Lady Rock 25]

I also had a 6 month requirement and my insurance also required to lose 5% of my weight or I would not qualify. I lost the 5% and my doctor is submitting me for approval on Monday, has my last weigh in and pre op with the doctor Saturday, and my surgery has been scheduled for 7-30 pending insurance approval..so wish me luck

[cebbert 1]

I'm curious, who is your insurance companies? I'm still waiting to hear from mine.

[Lady Rock 25]

I'm curious, who is your insurance companies? I'm still waiting to hear from mine.

My insurance is through BCBS Excellus

[ELPMax 1]

My insurance only required 3 Months of supervised diet. Though I had to journal everything (my co-workers would tattle on me if I didn't), I ended up loosing 21 pounds my last appointment before they scheduled my surgery. I was told by the surgeon that I would have to loose at least 15 pounds before he would even consider doing the surgery. Staff advised that I shouldn't gain any weight. Every 30 days I was in the office with my food journal and was told what things to modify.

I have never been told not to loose a certain amount of weight prior to surgery. But I started out at 424 pounds too. This may be a requirement for your insurance. Have you questioned the staff on this any? I am sure you would have no problems getting an answer from them.

[cebbert 1]

My insurance company is bcbs of Illinois.

[VSGFOX 1]

I have BCBS in California. They only require a psych evaluation & 6 month diet. I was so bummed to wait 6 months, but everyone keeps telling me it will go fast.

[dommie20 3]

Hi all. Thanks for your input. It's not the 6 month wait I'm concerned about. I'm worried about the weight threshold I would like to eat a healthier cleaner diet but if I lose too much weight the insurance company won't approve the surgery. I have emblem health. 6 months will fly right by and it gives me Time to really process what I'm doing and prepare myself for what will be a huge life change so I'm ok with that but two weeks before surgery I have to be on all liquids and then I'll have a new stomach and new eating habits. I would like to try now to sort of work myself Into that way of life but if I lose too much I won't be approved. Maybe I should talk to the surgeons office again.

[VSGFOX 1]

Yes, definitely talk with your surgeon... I'm going to do the same as well.

I agree with you 100% after my initial impatience to the 6 month wait, I started to look at it as an opportunity to really prepare myself. Best of luck

[dommie20 3]

Same to you VSG. keep in touch it's good to have a buddy!!!

[sunnkistme 76]

I am right at 40 BMI, My surgeon is doing my six month supervised diet. He advised that I weigh right at 40 for my nutrition appointment and then can lose as much as possible. I am looking at Ocober for my six months to be up.

[tmspears3 1]

I also have to do 6 months physician supervised dieting. I am 2 months in and it seems like forever. I have went through the blood work, phys eval, ultrasound, endoscopy, I confirmed with my insurance(BSBC AL) that they go off the first initial visit. So they want you to show weight loss. I agree 6 months seems like forever but it will be worth it.

Edited July 22, 2014 by tmspears3

[alwaysvegas 702]

Your insurance company should clearly state the requirements. The requirements vary from insurance to insurance.

My insurance required a BMI of at least 35 with two comorbidities or a BMI of 40 or higher. I started losing weight before I even started the 3-month nutrition, but my BMI was still 42 when I was first measured by the bariatric center. My surgeon said most insurance companies use your first BMI measurement to determine qualification. By the end of my 3-month nutrition my BMI was down to about 37, but the insurance still approved me. My insurance did state that I could not gain weight during the 3-month nutrition.

Edited July 23, 2014 by AlwaysVegas

[dommie20 3]

Hi all. I did speak again with the bariatric coordinator at my surgeons office and she said it's important I don't lose too much or I'll be denied. So I'm trying to maintain this 278 I'm at right now. I have emblem health. I'm so nervous about being denied!!!!