stabb009 27 Posted December 26, 2017 Will someone still get the surgery if they gained weight at last appointment or is the same weight as previous appt? I really did struggle for the holidays. This is my last appt before they submit to insurance. Will i get another month to prepare?Sent from my LGMP260 using BariatricPal mobile app 1 JeezLouise91 reacted to this Share this post Link to post Share on other sites
JLT281 13 Posted December 26, 2017 I think it depends on your insurance requirements. Mine (FEP Blue BCBS) just required me to complete 3 nutrition classes. I weighed 1 lb less at my last class/appointment and had no issues with approval. Share this post Link to post Share on other sites
FluffyChix 17,418 Posted December 26, 2017 Whatever the outcome, just don't skip it! In the end, it's not a big deal if you have to go one more month before submission. ((hugs)) I'm sure there are more out there and they are used to dealing with this situation! Share this post Link to post Share on other sites
stabb009 27 Posted December 26, 2017 Whatever the outcome, just don't skip it! In the end, it's not a big deal if you have to go one more month before submission. ((hugs)) I'm sure there are more out there and they are used to dealing with this situation! I think it depends on your insurance requirements. Mine (FEP Blue BCBS) just required me to complete 3 nutrition classes. I weighed 1 lb less at my last class/appointment and had no issues with approval. Thank you. I just cant get the last 5lbs off. Im thinking about Water pills or something. Its hardSent from my LGMP260 using BariatricPal mobile app 1 FluffyChix reacted to this Share this post Link to post Share on other sites
stabb009 27 Posted December 26, 2017 I think it depends on your insurance requirements. Mine (FEP Blue BCBS) just required me to complete 3 nutrition classes. I weighed 1 lb less at my last class/appointment and had no issues with approval.I had to do 6 months. And im on my last visit as of tomorrow. But the 5lbs keeps lingeringSent from my LGMP260 using BariatricPal mobile app Share this post Link to post Share on other sites
JeezLouise91 55 Posted December 26, 2017 Im in the same boat as you hun, I have to go to the hospital to be weighed and I have really struggled to excersize and eat better. Had a lot of stress as well as being the holiday period! I'm hoping we'll both be OK [emoji21]Surgery due January 17th 2018CW 238GW 133 Share this post Link to post Share on other sites
Introversion 1,876 Posted December 26, 2017 I'm embarrassed to admit I gained 25 pounds in the 6 months that elapsed while awaiting surgery. I still had surgery without any resistance from the surgeon or insurance company. So, yes, it's still possible to have surgery after pre-op weight gain depending on your surgeon and insurance company. Some surgeons will promptly cancel for a major weight gain whereas others don't care. Some insurance carriers won't approve payment for surgery with a major weight gain while other companies don't care. 1 FluffyChix reacted to this Share this post Link to post Share on other sites
stabb009 27 Posted December 26, 2017 Im in the same boat as you hun, I have to go to the hospital to be weighed and I have really struggled to excersize and eat better. Had a lot of stress as well as being the holiday period! I'm hoping we'll both be OK [emoji21]Surgery due January 17th 2018CW 238GW 133My starting weight was 252 and i haven't been under that since i started. Im 257 now and was 255 last appt....man im so over it. Im stuck. I was gonna take Water pillsSent from my LGMP260 using BariatricPal mobile app Share this post Link to post Share on other sites
stabb009 27 Posted December 26, 2017 I'm embarrassed to admit I gained 25 pounds in the 6 months that elapsed while awaiting surgery. I still had surgery without any resistance from the surgeon or insurance company. So, yes, it's still possible to have surgery after pre-op weight gain depending on your surgeon and insurance company. Some surgeons will promptly cancel for a major weight gain whereas others don't care. Some insurance carriers won't approve payment for surgery with a major weight gain while other companies don't care.I don't have a date yet. Tomorrow is suppose to be my final appt. For them to submit to insurance. But im like so nervous because i gained 5 instead of losing 5...Sent from my LGMP260 using BariatricPal mobile app Share this post Link to post Share on other sites
Brittanyblue 55 Posted December 26, 2017 5 hours ago, stabb009 said: Will someone still get the surgery if they gained weight at last appointment or is the same weight as previous appt? I really did struggle for the holidays. This is my last appt before they submit to insurance. Will i get another month to prepare? Sent from my LGMP260 using BariatricPal mobile app For my insurance as long as you weighed the same as the first appointment with the dietitian or less, you will be fine. It's different for every insurance company. I know that my surgeon said that if you gained weight by your surgery date they will post pone it, but i made sure I had all the weight i had gained (which was 4 lbs) off before my meeting with the surgeon! So you should be fine, put your mind to work this last month! You got this! I did gain 15 lbs total within the 6 months of dietitian visits but within the last 1.5 months I was able to get it all off and then some! If you got any questions let me know Share this post Link to post Share on other sites
TexasMommy80 297 Posted December 27, 2017 I have Cigna and my patient advocate warned that if you gain a single pound during the three months supervised diet, they will automatically deny it. I am more worried about that than the weight loss surgery itself. Share this post Link to post Share on other sites
TexasMommy80 297 Posted December 27, 2017 Oh and Cigna will deny you if you lose too much too, because you “can do it on your own.” Share this post Link to post Share on other sites
stabb009 27 Posted December 27, 2017 I have Cigna and my patient advocate warned that if you gain a single pound during the three months supervised diet, they will automatically deny it. I am more worried about that than the weight loss surgery itself. I have gateway. I was told to lose 8 lbs in 6 months....3% of my weight...idk...i hope i didn't mess it upSent from my LGMP260 using BariatricPal mobile app Share this post Link to post Share on other sites
Sullie06 1,013 Posted December 28, 2017 (edited) For my insurance and program you have to lose 5% of your body weight in order to be approved. If you lose the 5% and get sent for approval then gain it back they will postpone or cancel your surgery. As long as you lose that 5% any weight gain/loss doesn't matter. So for example if you are 300 pounds you need to lose 15 pounds and say you lose 20 but gain 5 back you're okay because you're still within that 5% but if you lose 15 and gain 2 back you are then out of the 5% approval range. You have to lose and maintain that 5%. But like other's have commented, every program and insurance company is different and have different regulations. Edited December 28, 2017 by Sullie06 Share this post Link to post Share on other sites
Wendyfm 494 Posted December 28, 2017 I gained while going through the process and had to lose what I had gained. When I did The process went ahead. Share this post Link to post Share on other sites