Went to my first seminar...i'm bummed

[Bozzj 0]

Hi All,

need to vent...and i know in a few days i'll think more positively, but i went to my first seminar yesterday --and met tracey from here :-) --and everything was really good. THEN they say that Horizon BCBS requires you go to 6 months of supervised diet. I knew there was a chance of this..and i know it's a step in the right direction, but i really wanted it now! I know i'm being a baby, but i'm disappointed. I have my first consult in two weeks and i guess i'll ask them how i go about this 6 months thing..and if we start any of the testing prior to then.

I was so sad last night that i was thinking of self-pay (which i know is stupid if my insurance will cover it...but i wasn't rational at that point) and to get it done in hackensack hospital it's 25k-32k!!! It's 15k in a smaller outpatient facility.

Anyone go through the 6 month diet? Do you go to your lap doctor for that? I'm not sure if that's possible, but i'm afraid if i go to my regular doc and he doesn't write the right thing i'll get denied. ALso, do you start all that testing AFTER 6 months months or do they start some of it during the waiting period? I'm confused. The seminar was packed and I'll ask him all this as well in the consult, but i'd appreciate your experiences.

I guess what is the most annoying is i diet all the time and i didn't doctument it with a doctor. AND if i could diet and not be starving all and and end up giving up...then i i wouldn't be getting the surgery in the first place. :cursing:

[Tracyde730 7]

Hi Jamie! Don't give up...I'm with you all the way. We'll figure this out! Don't forget to make your phone calls today... :cursing:

[vballmom 0]

The six month diet is pretty standard practice for insurance companies.

I had to do it, do not skip a month bec then you will have to start over.

First find out if your doctor approves of the lapband, bec you need the doctor to write a letter to the insurance co at the end of six months of a supervised diet. Make sure the doctor documents each visit with info about your diet and weight loss plan. I personally only lost 11 pounds in the six months. I know the six months wait sucks but it will give you time to learn more about the lapband and to prepare youself mentally. The surgeons office will advise you when to start the pre-op testing & doctor visits. Good luck with the process.

[lafevretj 0]

I completed my 6 month diet in december, I am currently having my four weeks of dietary counseling before lapband surgery. I haven't found out if my insurance has approved the procedure yet, but I should know in a week. I started the process last June, had my psycological eval., dietician consult, lab, Stress test, sleep study and EGD during the time I was on the 6 month diet. So far the process has been 8 months and my surgery (if approved by the insurance company), may not be for another month. The time has gone by so fast (and I have learned so much more than I knew when I started). I think the wait was definitely beneficial when I read posts from people who recently had surgery and really don't understand how the band functions, or didn't know what to expect after surgery. The best advice I can give you is to "educate" yourself regarding the band,during your wait. I know that I won't really know what it's all about until I have the surgery and "experience" it all first hand. Good luck!!

[MacMadame 81]

Hey, I just found out last night that my company* excludes this surgery from our plan even though the insurance company offers coverage. 6 months of a supervised diet is nothing compared to not being covered!

(*I do have this tiny hope that I'm just reading the plan summary wrong, but I don't think I am.)

[VegasGrace 1]

Don't give up!

If someone would have told me that if I would let them pay for it all I had to do was wait six months...I'd have to really consider that offer.

I was self pay so don't know what you are going thru...but I do know bummed.

Start today....mark your calendar and know in 6 months... August will be here before you know it. Enjoy all the fruits of the summer season and eat! And you will be enjoying your weightloss come summer's end....just in time for the holidays. This Thanksgiving will be a new you! (a different sized you, anyways)

Good luck!

[Sunwyse 1]

I still have 8 months to wait before I can be banded. We'd all love to have it done the day we decide we definitely want to go ahead, but life happens. See it as a life long journey. This 6 month diet requirement is just the first part of that journey. Don't see it as the operation being the start, but rather the next phase along.

[eigna 0]

I started when you had to do 12 months, BCBS they just changed it in January. My personal Doctor gave me 4 months, If you go to a doctorly monthly for BP or weigh in, this can count. I went in Jan and was told the rules had changed, I could have it any day, I got cold feet.

[Elisabethsew 50]

I have Empire BCBS PPO and they too demand a 6 month medically supervised diet. It takes up to 3 months to get all the testing done so make an appointment today and start documenting. My MD documented weight watcher attempts and that counted so explore all options.

[Guest nicenurse]

Hi, well i think a lot of groups say that. i have friends whose doctors simply weighed them each time. the group i am in states they would like you to lose some weight, but not required.

Talk with your doctor.

[Laura_MD 5]

I was very lucky, BC/CS accepted my Weight Watchers booklets as proof of my following the plan for 6 months and I only had to wait long enough to do all the pre-op evals and stuff! Definitely ask if what ever you have been doing counts and ask you regular doc when the last time you were there was. Most of us have co-morbidities that require monthly (at least) visits to the doc. If they weighed you (which they almost always do), then it may count!

Ask questions, check records, there are lots of things that count toward your six months that you might not think would. Weight Watchers for instance is a little known exception because it is designed and managed by a team of physicians, it is considered medically supervised. I don't know about curves or any of the other programs but it is worth checking it our if you have been attending.

Eigna, why are you getting cold feet? If you can share, maybe we can help.

Laura

[Teresa-jade 0]

I have not been banded yet but what I say might be helpful. I have BCBS insurance and they require a 12 month supervised diet b4 lapband surgery. Like you I have been on diet after diet with no documentation so I was really upset at having to wait a year. So I appealed that decision with my insurance company and won. I sent my original request in Nov 21 -07, received a note from my insurance that I had to wait 12 months on Dec 27 - 07, I sent in my appeal on Jan 16th -08 and got word on valetines day (2 days ago) that I won the appeal. So I would tell anyone to appeal and get your doctors to write recommendations that the lapband would be good for you. That's what I did and it paid off. Good luck to you.

[JustCallMeKelly 0]

Bozzj, I too had the same thing happen to me so I totally know how upset and dissapointed you are feeling right now....But, with that said, I'll tell you that it turned out to be a great thing for me to have to wait the 6 months. First and foremost it gave me plenty of time for me to "wrap my head around" the fact that I would be giving up my old way of life. I had time to read about 14 books on the subject and once i found this website and found out what a terrific source of information it was the time just flew by. The way my surgeon's office handled the 6 months was as follows: 1st Month appt. he explained how it was all going to happen. He told me that he didn't need me to lose weight BUT he didn't want to see me gain not one single pound...or else!!! 2nd month appt. I met with the dietician...3rd month appt. met with the in office Diet Person - got weighed in....4th month appt. met with Pshcyologist for evaluation (mandatory for my insurance)...5th month appt. meet with in office Diet person again - got weighed in again...6th month appt. met with Surgeon for the "liver talk", then got surgery scheduled and came back one last time for pre-surgery talk with Surgeon....then surgery!!! The time flew by and at first I didn't really take it serious and ended up gaining 7 lbs...but then they gave me a strong talking to and explained how if I didn't do as I was told then I could get cancelled at the last minute for the weight gain, due to the enlargement of the liver from the gain. So after that I got serious and ended up losing 9 lbs. then another 6 before surgery. Since surgery I've had 2 fills with a 3rd scheduled for 2nd week in March. I've lost 46 lbs. and have never felt better. Anyway, hope this helps you feel alittle better. Good luck. Live well/Be well. KKG