6 month supervised diet

[Shell425 15]

I Would just like I know whether or not anyone gained weight during the supervised pre-op diet? Did anyone have problems with the insurance accepting their authorization for gaining weight? My brother and I both just submitted our papers to the insurance company. I lost about 20 lbs the first 3 months and the last 3 months I managed to gain it back plus about 10... My dr hasn't mentioned that being much of a problem but waiting for this authorization is making me overthink everything!!!

[KSTUZ 438]

As long as u didn't have a 'Net Gain' which is a gain over where u started...than u should be ok.

I had a net gain, and I was denied. I have Aetna.

Every place is different, but if it was all submitted with a net gain, u may have to look up ur ins company's rules for bariatric surgery. They will list the exclusions on why they won't cover it.

I had no idea either, but it was my job to make sure I knew the rules of Aetna.

So now I'm appealing and hoping for the best...

Good luck!

[race2sleeve 0]

I was denied because I gained two pounds over my initial weight. I have Kaiser. I was told to lose those pounds again plus 15 more before I could get approval. One year later still not approved. I have PCOS so weight losses is hard!

[jojoreno 62]

I have Aetna and did the 6 month weight loss 14 pounds and now they want my weight for 2012 when I didn't have insurance. Mine is still pending even after calling my Dr to fax my weight to insurance for 2012. BMI is now 39. Praying I get approval.

[Westfield27 54]

I have Aetna and did not know that I couldn't gain weight. Seven days after my paperwork was submitted I got the call that I was approved after being told by the surgeons office that there was a 90% chance that I'd be denied. I have even heard of others being denied for gaining weight. Since I was approved I say everyone's different I wouldn't worry about it to much until you get an answer you may have other issues that help your cause.

[ayscott74 99]

I have Aetna and did the 6 month weight loss 14 pounds and now they want my weight for 2012 when I didn't have insurance. Mine is still pending even after calling my Dr to fax my weight to insurance for 2012. BMI is now 39. Praying I get approval.

[ayscott74 99]

I have Aetna too and had to do 6 month finished the 6 month july they sent everything to insurance company 1 week after the last visit got approve 4 day later.

[jojoreno 62]

That's great! I finished in July too but mine is still pending and it's going on 2 weeks.

[Shell425 15]

Thanks so much for all the feedback! I have bcbs of Texas, I'm crossing my fingers still since I'm still waiting for a call from the dr, but hopefully I'll hear this week! Good luck to all of you!

[RedDirtRoads 64]

Shell, please follow up here. I have BCBS of OK and I believe we are under the same rules. I didn't know that I couldn't gain weight, I just went to my first appointment on Friday. I was 10 lbs under having a 40 BMI and honestly was thinking about just trying to gain the 10 so I would meet insurance requirements BECAUSE my doctor said he doesn't send anyone for sleep studies or anything besides psych and nut evals. I am nervous about being denied! Good luck.

[Shell425 15]

<p>Shell, please follow up here. I have BCBS of OK and I believe we are under the same rules. I didn't know that I couldn't gain weight, I just went to my first appointment on Friday. I was 10 lbs under having a 40 BMI and honestly was thinking about just trying to gain the 10 so I would meet insurance requirements BECAUSE my doctor said he doesn't send anyone for sleep studies or anything besides psych and nut evals. I am nervous about being denied! Good luck.</p>

So just a follow up here, I haven't heard from the insurance company yet. Hopefully it comes soon! I did talk to my dr and he said that my supervised diet didn't have any terms to follow so it doesn't matter if my weight fluctuated! Still have my fingers crossed! This wait is killing me!!!! Lol

[tmspears3 1]

I also have BCBS AL, I have 6 months dr supervised and nut dieting. I was told that they go off your first weigh in and for me not to gain any weight or I would be denied

[Shell425 15]

I was accepted! Surgery date is sep 9th!!!

[lindalue 70]

I was accepted! Surgery date is sep 9th!!!

So happy for you Sept 9 will be here before you know it good luck and keep us posted

[jojoreno 62]

I finally checked with insurance and I was accepted. Yeah! Then I called western bariatric and they said I was accepted yesterday and they didn't even call me. Then they said someone would call me in a week really. So now more stress.