6 month superzied diet question

[mammanan 0]

My insurance coverage requires 6 month supervised diet before surgery.. I have done this before but too long ago to get documentation... But have failed miserabley at keeping off many shorter/unsupervised attempts in the past (enough dieting and regain to be a BMI of 46)

What if I lose the thirty or so lbs to bring BMI to less than 40...

Do I have to regain to get the long term help ( ie band) that I need ? Anyone else been there?

[Savedbygrace 11]

Sometimes I think it's almost a trick to see if they can deny it due to your BMI being below the 40. I don't really have an answer other than I was advised to loose some but that they WILL deny it if you loose below the required 40 BMI (or 35 with comorbids) Sounds terrible to say loose some.. but not alot.. but from my experience.. that's what works. I only lost 13 pounds in the 6 months and was approved. Good luck!

[Elisabethsew 50]

The purpose of the 6 month diet is to prove to the insurance company that you can't lose a significant amount of weight. If you've done this in the past, have your MD write a letter to the insurance company. It's also a VERY good idea to call the insurance carrier and ask them to send you the requirements so you don't have any surprises.

[Brandy~ 2]

My insurance coverage requires 6 month supervised diet before surgery.. I have done this before but too long ago to get documentation... But have failed miserabley at keeping off many shorter/unsupervised attempts in the past (enough dieting and regain to be a BMI of 46)

What if I lose the thirty or so lbs to bring BMI to less than 40...

Do I have to regain to get the long term help ( ie band) that I need ? Anyone else been there?

You and I are in the exact same situation. I have BCBS of Minnesota. I have a required 6 month supervised diet plan with a dietitian. I have completed 5 of them!!! I also used to do this same thing in 2004 which is too long ago... So what I have done so far is:

I went back to the dieitian I used to see in 2004 told her what I was there for... She talks to me about how to eat healthy and what I am doing. She weighs me in while I am there and then sends me on my way. She sends her monthly report to my doctor as well. When I am done with all 6 appts. She is going to write a letter summarizing my visits in 2004 and document the weight loss then and the gains since. Then she is going to document the 6 current months and send a summary of the findings to my doctor.... Once he has all that he is submitting for authorization. I know it sounds like alot... But all I had to do was be honest with the dietitian. I explained to her my long term goal being lap band and she was more than happy to help me. She even looked over the section in my insurance handbook to make sure she was following their criteria so that I hopefully wont have to appeal.

Good luck and it really isn't that hard to set it all up... The hard part is finding the patience to wait it all out. Someone else on this board told me once.... were always waiting on something...

[Pnw_Red 2]

My insurance specifies in their paperwork that the weight they use is the weight at the BEGINNING of the six months. I have BCBS of Illinois.

And honestly, I've been told that the six months is to show you CAN'T lose weight and I've been told it's to show that you CAN lose weight. Nobody really knows for sure.

[Brandy~ 2]

My insurance specifies in their paperwork that the weight they use is the weight at the BEGINNING of the six months. I have BCBS of Illinois.

And honestly, I've been told that the six months is to show you CAN'T lose weight and I've been told it's to show that you CAN lose weight. Nobody really knows for sure.

I have heard it both ways as well. I went safe.. I changed the way I eat.. I haven't lost a boatload of weight but I have lost about 10 pounds. I still have a couple weeks till my last appt and I plan to lose a couple more pounds before I get weighed in for the last time.

[Angie4b1g 1]

I keep reading the title of this thread as "supersized diet". That's the one I was on before the band, for sure. :drool:

[Savedbygrace 11]

LOL Angie! Amen! Thanks for the chuckle!! :-)

[Cocoabean 430]

I was denied a consult with my surgeon due to lack of a 6 month supervised program.

I appealed due to the fact that the National Institues of Health does not recommend a 6 month program as a requirment for bariatric surgery.

I quoted info from the following:

The National Institutes of Health (NIH) Consensus Development Program: Gastrointestinal Surgery for Severe Obesity

I also included diary entries from previous attempts and Weight Watchers attendance records from past tries.

I won the appeal :drool:

However, the rest of the hoops I needed to jump through for my insurance took about 6 months, but I didn't have the "supervised program" to contend with.

My surgeon has a dietician on staff that I met with monthly after my consult so that if the insurance went back and required it, I'd have it started.

But if not for my appeal, I'd not have been able to see my surgeon until AFTER the 6 months.

Denise

My insurance coverage requires 6 month supervised diet before surgery.. I have done this before but too long ago to get documentation... But have failed miserabley at keeping off many shorter/unsupervised attempts in the past (enough dieting and regain to be a BMI of 46)

What if I lose the thirty or so lbs to bring BMI to less than 40...

Do I have to regain to get the long term help ( ie band) that I need ? Anyone else been there?

[mammanan 0]

TY for all the feedback

What a great place for support and feedback !!!

( I think I'm gonna like it here)