Waiting period? Incredibly frustrated!

[sassyfrass23 525]

Hi! I'm new here and hoping someone can give me peace of mind. I am almost finished with my 6 months of supervised diet and exercise. My last weigh in is actually in November. I meet the 40 BMI criteria with a 41 and have one co-morbidity although not required unless I am below 40. However, I have spoken to UHC 4 times in the past week and am so confused about when I can actually have surgery. After I receive authorization, which will hopefully be in December, I was told by one rep that I have to wait 6 months from approval date to have surgery. When I called back, the next rep said she'd check with the clinical reps, which she did, and they told her they didn't have any stipulations on their side that required an additional 6 month waiting period. It's not even for dieting/exercise purposes. Just simply waiting. And then tonight- another rep said I do have to wait, per a different clinical rep he spoke with. Has anyone experienced or even heard of this waiting period? I would think all tests/evaluations/data would be out dated after 6 months.

[SuperDave 1,115]

My guess would be that the reps are confusing the 6 month medically supervised weight loss with a 6 month waiting period. I haven't read about anyone else having a wait like that. Once I finished everything I had to do and got approval surgery was scheduled 3 weeks out.

[sassyfrass23 525]

That's exactly what I though, SuperDave! But the way he read it was something like "authorization must be obtained 6 months prior to surgery." What? I hate insurance...

[Mania 128]

So each plan is different but I also have UHC. I was authorized by UHC within a week.

[Inner Surfer Girl 12,015]

I suggest you talk to the insurance coordinator in your surgeon's office. They tend to be pretty familiar with the different insurance companies and may have a better contact person.

[Jangy03253 56]

I also have UHC. I had the 6 month diet also. It only took them 2 days for the insurance to give approval after they got clinicals from my doctor. Once you get approval it is up to your doctors office schedule. I am waiting to see if I can get in this year. I have had approval for a week. I am on the affordable care act insurance and I was told that my plan will not be available next year. So I still have fingers crossed for December.

[sassyfrass23 525]

I honestly don't foresee my authorization being an issue. However- I could be completely wrong. Insurance can be so difficult that I truly don't know what to expect. Although I've heard mostly good things about UHC.

I just don't understand why insurance would approve you and then require you to wait 6 more months. It makes absolutely zero sense to me.

Jangy- fingers crossed things fall into place for you! I can't imagine how nerve wracking that time line is for you :|

[sassyfrass23 525]

Either way- you all made me a little more hopeful than what I was when posting this. I'm hoping that the insurance coordinator, as mentioned above, will be able to confirm this quickly. And hopefully prove that the insurance reps were all confused

[Jangy03253 56]

I honestly don't foresee my authorization being an issue. However- I could be completely wrong. Insurance can be so difficult that I truly don't know what to expect. Although I've heard mostly good things about UHC.

I just don't understand why insurance would approve you and then require you to wait 6 more months. It makes absolutely zero sense to me.

Jangy- fingers crossed things fall into place for you! I can't imagine how nerve wracking that time line is for you :|

Thank you very much. It has been crazy. With no cigs and on a diet my emotions have gone crazy. I have no support at home. So I come to these pages. But today when I was physically ill from my nerves. I made the decision that it will happen if it is gods will. If it is not his will then I will not get on the schedule. I can't make myself sick or depressed. Matter of fact I think I need Protein so hubby gonna take me to cheer me up with steak. A much smaller steak then I used to eat and salad in place of sweet potatoe. So it's not breaking my diet to aweful.

[shellyd88 463]

I have found that the dr or clinic/ program likes to verify your insurance coverage and approval before they begin your mandatory weight loss nutrition appts and all testing begins a lot of insurance make you have some period of time to have weight loss usually required by the surgeon not the insurance but the insurance goes along with this as there is a chance u will quit or get tired of all the bs and change your mind I've also found that they will never give a straight answer

[sassyfrass23 525]

I so badly hope so Shelly! The thought of waiting an additional 6 months is really bothering me. But- for some reason, I have a gut feeling that insurance is wrong with the information they gave me. Or at least I pray they did. I have been doing my supervised weight loss with my PCP. I completed my online seminar and registration for my surgeons office this past weekend so they should be contacting me soon. I also included my insurance information, so I am hoping the insurance coordinator will have more reliable information for me!

[hollybower 122]

That's exactly what I though, SuperDave! But the way he read it was something like "authorization must be obtained 6 months prior to surgery." What? I hate insurance...

My insurance requires the 6 month dreaded wait...but I have never heard of an additional wait! It is also my personal experience that the more you call and question, the more crazy answers you end up getting! I know it's crazy frustrating but just let your surgeons office handle it.

[hollybower 122]

I so badly hope so Shelly! The thought of waiting an additional 6 months is really bothering me. But- for some reason, I have a gut feeling that insurance is wrong with the information they gave me. Or at least I pray they did. I have been doing my supervised weight loss with my PCP. I completed my online seminar and registration for my surgeons office this past weekend so they should be contacting me soon. I also included my insurance information, so I am hoping the insurance coordinator will have more reliable information for me!

So about this supervised diet, that is what I'm doing now. She didn't give me a specific diet just things to try and cut back on. Did you lose any weight? I'm scared to lose to much that would disqualify me for the surgery. Help!

[sassyfrass23 525]

I agree. I spoke with the insurance coordinator this afternoon when she called to schedule my appointment and she put me at more ease. She said she'd never heard of this stipulation before so she would be incredibly surprised if that was the true case. So, fingers crossed that it was all a mix up and she is correct!!

That's exactly what I though, SuperDave! But the way he read it was something like "authorization must be obtained 6 months prior to surgery." What? I hate insurance...

My insurance requires the 6 month dreaded wait...but I have never heard of an additional wait! It is also my personal experience that the more you call and question, the more crazy answers you end up getting! I know it's crazy frustrating but just let your surgeons office handle it.

That's exactly what I though, SuperDave! But the way he read it was something like "authorization must be obtained 6 months prior to surgery." What? I hate insurance...

My insurance requires the 6 month dreaded wait...but I have never heard of an additional wait! It is also my personal experience that the more you call and question, the more crazy answers you end up getting! I know it's crazy frustrating but just let your surgeons office handle it.

[sassyfrass23 525]

@hollybower I've seen such convoluted information on this topic. A lot of it depends on your insurance and what they're looking for. Do you lose weight? Maintain? Make sure you don't gain? What happens if you go below your starting BMI and what if you drop below the required BM? I honestly have no idea what I'm doing myself. I've lost about 7 lbs which is still above my required BMI, but it's nerve wracking. Will the fact that I lost 7 lbs and have kept it off make my insurance company think I'm capable of doing it on my own? I surely hope not since that's like..1.1 lbs a month. Haha- not ideal for a successful weight loss program in my opinion. What insurance company do you have?

I so badly hope so Shelly! The thought of waiting an additional 6 months is really bothering me. But- for some reason, I have a gut feeling that insurance is wrong with the information they gave me. Or at least I pray they did. I have been doing my supervised weight loss with my PCP. I completed my online seminar and registration for my surgeons office this past weekend so they should be contacting me soon. I also included my insurance information, so I am hoping the insurance coordinator will have more reliable information for me!

So about this supervised diet, that is what I'm doing now. She didn't give me a specific diet just things to try and cut back on. Did you lose any weight? I'm scared to lose to much that would disqualify me for the surgery. Help!