Denied! ????

[Sandra86says 92]

So I got the call today.... Bad news! Insurance denied my WLS request, I need to provide 6 months of documented weight loss efforts. I told the coordinator I've been on weight watchers numerous times since 18, I'm now 29... She said insurance requires those efforts to be within the past 18 months... I'm so bummed! I've been obese since 18! Isn't that enough?! I guess I'll start to make appointments with my PCP monthly to discuss my goals... What good is that going to do? I started this journey in February, I could've done appointments then! I would've been done by next month! I just feel that I'm wasting time! Then again, who knows, I may need to come to terms with my eating habits medically, to prepare me for my surgery! Maybe it's a good thing? Just need support and advice! Has anybody been denied due to undocumented weight loss?!? What was your experience?? Thanks so much!!!

[wagers0990 0]

My insurance required 6 months of diet classes, pysc visit, and a sleep study.

[animallover1247 249]

Don't feel bad, we all have setbacks. I called today to get my consultation and was told I had to take the class FIRST. The next class is over a little month away,plus the 6 month period for the insurance and then waiting for the doctor to schedule! Hang in there!

[Elode 8,093]

Write them a list. That's what I had to do. Do they want physical proof? I just had to write down everything I had tried.

[urukugal 3]

Check out other options...other places for surgery... Support groups on Facebook.... Ck out www.doctoraltamirano.com

Dr. Carlos Altamirano on here ...he's amazing...

Edited July 22, 2015 by urukugal

[Monnie815 64]

Write them but go ahead and start diet log. Get your pcd to write them on your behalf also.

[naturegirl 320]

All insurance companies are different. A friend of mine chose a different health insurance plan then me (same employee) and had go complete the 6 month supervised diet, while all I had to do was list out my dieting attempts. It comes down to talking with your insurance company early in the process to identify the steps needed.

While discouraging think of it as an opportunity to start working on some of the post-op and pre-op responsibilities and life changes.

[MissRobin 93]

@@Sandra86says have you considered self pay surgery in Mexico? It is less than $4200

[calmclear 4]

So I got the call today.... Bad news! Insurance denied my WLS request, I need to provide 6 months of documented weight loss efforts. I told the coordinator I've been on weight watchers numerous times since 18, I'm now 29... She said insurance requires those efforts to be within the past 18 months... I'm so bummed! I've been obese since 18! Isn't that enough?! I guess I'll start to make appointments with my PCP monthly to discuss my goals... What good is that going to do? I started this journey in February, I could've done appointments then! I would've been done by next month! I just feel that I'm wasting time! Then again, who knows, I may need to come to terms with my eating habits medically, to prepare me for my surgery! Maybe it's a good thing? Just need support and advice! Has anybody been denied due to undocumented weight loss?!? What was your experience?? Thanks so much!!!

Have you considered having your surgery in TJ, Mexico? It's not the 3rd world, has great doctors and you can get surgery, hotel, and such completely done for around $4000. Just put it on a credit card and get it done!

So I got the call today.... Bad news! Insurance denied my WLS request, I need to provide 6 months of documented weight loss efforts. I told the coordinator I've been on weight watchers numerous times since 18, I'm now 29... She said insurance requires those efforts to be within the past 18 months... I'm so bummed! I've been obese since 18! Isn't that enough?! I guess I'll start to make appointments with my PCP monthly to discuss my goals... What good is that going to do? I started this journey in February, I could've done appointments then! I would've been done by next month! I just feel that I'm wasting time! Then again, who knows, I may need to come to terms with my eating habits medically, to prepare me for my surgery! Maybe it's a good thing? Just need support and advice! Has anybody been denied due to undocumented weight loss?!? What was your experience?? Thanks so much!!!

Have you considered having your surgery in TJ, Mexico? It's not the 3rd world, has great doctors and you can get surgery, hotel, and such completely done for around $4000. Just put it on a credit card and get it done!

So I got the call today.... Bad news! Insurance denied my WLS request, I need to provide 6 months of documented weight loss efforts. I told the coordinator I've been on weight watchers numerous times since 18, I'm now 29... She said insurance requires those efforts to be within the past 18 months... I'm so bummed! I've been obese since 18! Isn't that enough?! I guess I'll start to make appointments with my PCP monthly to discuss my goals... What good is that going to do? I started this journey in February, I could've done appointments then! I would've been done by next month! I just feel that I'm wasting time! Then again, who knows, I may need to come to terms with my eating habits medically, to prepare me for my surgery! Maybe it's a good thing? Just need support and advice! Has anybody been denied due to undocumented weight loss?!? What was your experience?? Thanks so much!!!

Have you considered having your surgery in TJ, Mexico? It's not the 3rd world, has great doctors and you can get surgery, hotel, and such completely done for around $4000. Just put it on a credit card and get it done!

Sorry I don't know why it posted 3 times and I can't edit to remove it!

Edited July 23, 2015 by calmclear

[julias1119 27]

So I got the call today.... Bad news! Insurance denied my WLS request, I need to provide 6 months of documented weight loss efforts. I told the coordinator I've been on weight watchers numerous times since 18, I'm now 29... She said insurance requires those efforts to be within the past 18 months... I'm so bummed! I've been obese since 18! Isn't that enough?! I guess I'll start to make appointments with my PCP monthly to discuss my goals... What good is that going to do? I started this journey in February, I could've done appointments then! I would've been done by next month! I just feel that I'm wasting time! Then again, who knows, I may need to come to terms with my eating habits medically, to prepare me for my surgery! Maybe it's a good thing? Just need support and advice! Has anybody been denied due to undocumented weight loss?!? What was your experience?? Thanks so much!!!

Have you seen a surgeon yet? The reason I ask is some surgeons can help you complete the 6 month requirement so you make sure you do exactly what you need to do in order for your insurance to accept it. The last thing you'd want is to sirens the next 6 months doing dr supervised weight loss only to get denied again because your pcp didn't document it the exact right way your insurance requires.

[The Candidate 3,215]

The good news is it's not actually a denial, just a postponement. I know it's heartbreaking to think of an additional six months of requirements and waiting, but use the hope of a new healthy life as inspiration. You'll be surprised how fast the time will fly by!

Good luck!

[Daisee68 2,493]

Unfortunately bthis is very common with all insurance. Most of us here had to meet with a nutritionist for 3 to 6 months before we could get approval. Your surgeon is generally able to help you with those appointments. My insurance (Cigna) said it would accept Weight Watchers with Dr supervision but it had to be documented within the last 12 months (or something) which I didn't have. The visits with the nutritionist were very helpful in preparing for the surgery / post-op life.