Worried I will never get band.

[ladyblue9902 0]

I was told I have to do the 6 mo Dr supervised weight loss plan. I am just @ 40 BMI. (40.01) I actually had to gain 10 lbs to get there. Now I am worried I will put out all this money on Dr bills and just be denied because if I lose even 10 lbs I will not qualify . The surgeon I went to see said they do not submit anything to insurance until after I do the 6 mo diet because they said I would just be denied and have to appeal, but they will have to go w/ the weight I am after the 6 mo is up. I have HUMANA Insurance. I did not have any idea they covered weight loss surgery when I took out the plan . My past insurance company did not for any reason. So I had pretty much given up on the thought of ever having the Lap band. I was just trying to find a good insurance company that had co pays and was not sky high as I am self employed & it is very hard to find good affordable health care coverage. So I was very excited when I got my new insurance & the book said weight loss surgery was covered if U were clinically obese. The catch is that when I spoke w/ the insurance agent that set me up w/ Humana he asked me my weight height etc.. I told him I was 220 lbs & 5'7" which @ the time I was... (I had lost 25lbs over summer):smile:. Anyhow he was a independent salesman and before he put me on the phone w/ the Humana Rep he said "Oh by the way I put U on a SLIM FAST diet lol so if they ask ur weight U are now 200 lbs". I was like well OK... I figured if he works for them and is telling me to fib about my weight it must not be a big deal so I did :smile:. Keep in mind @ that time I was not even thinking my weight would really ever matter to them. As I do not have any real problems from my weight except aches & pains & slightly elevated blood pressure & I knew I would most likely not be w/ this insurance company for ever. So my BIG WORRIE is now that I have gained 30 lbs but it looks like 50 lbs to as far as Humana is concerned. Are they going to say u lied about ur weight so we are not only going to not approve u but were going to terminate ur policy. I feel like I'm in limbo I just don't know what to expect?? Any thoughts or advice on this is would be truly appreciated. Sorry this was so long. This is my first post & I guess I poured all my questions, problems etc... in to it LOL

[Catalystmb 2]

We're in the same 6 months of waiting boat.

I ws told by others who had my insurance that there is no 6 month doc sup diet but my surgeons office says yes.

I had my first visit to my doc early in Jan so I called her up and told her that we will be weighing me and logging progress for 5 more months.

It's a bit of a bummer but it's what must be done.

Stick with the weights you reported.

Getting trapped in lies and errors now can cause troubles with the approval.

I hate redtape.

Good luck to you.

[la8again 0]

I also have Humana and I do not have to do the supervised diet. I have my first apt tomorrow, but I spoke with Humana and they told me on my plan they do not require the diet. I am lucky they also cover the $550 office fee for the after surgery diet class. I am so sorry to hear that they dont cover that on your plan, but I have read on here about people saying that the insurance and the doctor use your first weight not the after diet weight. I hope you can figure something else out. You could try to speak with humana and see which weight they will use. I know they have a seperate weight loss surgery department they will know more than anyone else. I hope I was some help!