6 month preop requirements

[Tara1992 79]

I totally agree @@audaciousmarie they're All about the $$$ but they lose $ with people like me! Lol. Wow just read your story, I'm so happy for you. There is nothing wrong with coming to terms that you weren't ready. Now you are ready and seem determined! Best of luck, do you know when your surgery will be yet?

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Thanks so much! I definitely hope that my story lets others around me know they are not alone in this battle. Kaiser is a little bit different so I havent received a date yet. I just need to lose about 10 more pounds and then I will get my date.

Sent from my SM-G925T using the BariatricPal App

I'm sure there are other people who will greatly appreciate you telling your story and will feel less alone! Oh ok! Good luck! I'm not sure what kind of diet you're on but what works best for me is cutting the carbs! And I loooooveeeeee Pasta so it's so hard but always think of the end result! A confident and healthier you!

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[kmorri 1,689]

I am 54 years young and have fought weight all my life. I am in the 6 month period for qualification for my insurance to cover my surgery. I am working hard at starting to develop the habits post surgery now. What if u end up doing just enough that my bmi drops just below qualifying for surgery? Does that happen or do they use your starting bmi as the marker? I am 100 lbs overweight anyway. Thoughts?

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Please be very careful with this.....it is different depending on the Insurance plan you're on. Just because some insurance plans just use your initial weight doesn't mean yours will.....For example with mine I had to ensure my BMI never dropped below 40 during the whole process. Finally once they submitted my paperwork to the insurance for approval I was in the clear.....I didn't start my pre-op diet (liver shrinking) until after the approval.

So you need to make sure you check with your insurance and your bariatric team regarding your specific requirements. It would be terrible to go through that long process and a lack of understanding be the reason you're not approved.

Good luck to you! Keep us posted on how you're doing.

[Clarevoyant 347]

@@kmorri Completely agree! My insurance says it must be 6 months of a FAILED weight loss program. I am teetering on the edge because it has been hard not to start healthy habits now. It gets submitted to insurance next week so hopefully I'll know soon. Surgery scheduled for 7/18

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[kmorri 1,689]

@@kmorri Completely agree! My insurance says it must be 6 months of a FAILED weight loss program. I am teetering on the edge because it has been hard not to start healthy habits now. It gets submitted to insurance next week so hopefully I'll know soon. Surgery scheduled for 7/18

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Congrats on your surgery date!!! The period of time that I was having to make sure I didn't fall below a 40 bmi was the weirdest period of time in my life......never have I ever had to make sure I didn't cut back too much and make sure I DIDN'T lose weight.......it was a very weird feeling!....but as soon as the paperwork was finally sent off to my insurance I got real! I had my surgery of 5/16 and I'm down a little over 43 pounds from my highest weight....This is the best thing I've ever done for myself!! It's totally worth it!!

[Clarevoyant 347]

@@kmorri Congrats! That is awesome!

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[audaciousmarie 161]

I totally agree @@audaciousmarie they're All about the $$$ but they lose $ with people like me! Lol. Wow just read your story, I'm so happy for you. There is nothing wrong with coming to terms that you weren't ready. Now you are ready and seem determined! Best of luck, do you know when your surgery will be yet?

Sent from my SM-G900T using the BariatricPal App

Thanks so much! I definitely hope that my story lets others around me know they are not alone in this battle. Kaiser is a little bit different so I havent received a date yet. I just need to lose about 10 more pounds and then I will get my date.

Sent from my SM-G925T using the BariatricPal App

I'm sure there are other people who will greatly appreciate you telling your story and will feel less alone! Oh ok! Good luck! I'm not sure what kind of diet you're on but what works best for me is cutting the carbs! And I loooooveeeeee Pasta so it's so hard but always think of the end result! A confident and healthier you!

Sent from my SM-G900T using the BariatricPal App

Thanks so much! I completely agree...cutting carbs does work best for me. Especially because I have been pre diabetic before and when I cut my carbs and increased Protein..my A1C went down so fast. I'm just trying to stay focused on the low carb, 3 meals a day plan my surgeons's office has me on so I can get my date!☺

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[audaciousmarie 161]

I am 54 years young and have fought weight all my life. I am in the 6 month period for qualification for my insurance to cover my surgery. I am working hard at starting to develop the habits post surgery now. What if u end up doing just enough that my bmi drops just below qualifying for surgery? Does that happen or do they use your starting bmi as the marker? I am 100 lbs overweight anyway. Thoughts?

Sent from my SM-N920V using the BariatricPal App

Please be very careful with this.....it is different depending on the Insurance plan you're on. Just because some insurance plans just use your initial weight doesn't mean yours will.....For example with mine I had to ensure my BMI never dropped below 40 during the whole process. Finally once they submitted my paperwork to the insurance for approval I was in the clear.....I didn't start my pre-op diet (liver shrinking) until after the approval.

So you need to make sure you check with your insurance and your bariatric team regarding your specific requirements. It would be terrible to go through that long process and a lack of understanding be the reason you're not approved.

Good luck to you! Keep us posted on how you're doing.

Thanks for that info. I have never heard of am insurance making you stay at at least a 40 bmi (although I know ins. companies look for the slightest reason to deny smh). If you don't mind...what insurance was this? I'm just curious

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[kmorri 1,689]

@@audaciousmarie Blue Cross and Blue Shield.......but again it's not the insurance company it the specific plan that determines the rules. (in other words all BCBS plans won't have the same requirements) Not only do I have BCBS insurance I have 29 years of experience working for them.... I just retired in September......

This is a very common requirement so it's always best to check with your insurance company so they can tell you the specific requirements of your plan.

[audaciousmarie 161]

@@audaciousmarie Blue Cross and Blue Shield.......but again it's not the insurance company it the specific plan that determines the rules. (in other words all BCBS plans won't have the same requirements) Not only do I have BCBS insurance I have 29 years of experience working for them.... I just retired in September......

This is a very common requirement so it's always best to check with your insurance company so they can tell you the specific requirements of your plan.

Oh ok. So true. It really can be an individual experience depending upon your insurance plan.

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[WitchySar 244]

It does seem to be very specific to the plan. I have Colorado Medicaid and the requirements state that if your medically supervised diet makes you fall below the BMI limit (35 w/ comorbidities, 40 w/o) they MAY deny you. Not that they necessarily WILL, but they look at each case individually.

[audaciousmarie 161]

It does seem to be very specific to the plan. I have Colorado Medicaid and the requirements state that if your medically supervised diet makes you fall below the BMI limit (35 w/ comorbidities, 40 w/o) they MAY deny you. Not that they necessarily WILL, but they look at each case individually.

Wow...this is very eye opening. I had no idea. I have been very fortunate to have had two different surgery programs that didnt care if I fell under 40 bmi

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[Alex Brecher 10,502]

@@tholbert08, Great question! You definitely want to know ahead of time what the requirements are so you don’t accidentally get disqualified. I don’t know the rules are for your particular insurance plan, but I do know this: You are best off finding out, and getting it in writing. You don’t want any disappointing surprises when it comes time to get the surgery.

Good luck!