6 months and counting

[Mystyblu 0]

Just got the insurance requirments for lap band surgery. I have all of the required documentation except the 6 months of doctor supervised weight loss. That seems to be Aetna's sticking point. It is so frustrating. I am all geard up and excited about beginning my jurney to band land and I find out I have to wait 6 months.

Question

What happens if I follow the weight loss program and happen to loose too much weight?? :cry

[kari jo 0]

If your surgeon/pcp really wants you to have to surgery he/she can help you to not lose too much weight. They know that the chances of it staying off long term are slim - statistics show it.

Get into your pcp and get the 6 month diet started asap so you can get your approval as soon as possilbe. Good luck to you!

[rene2005 0]

Yea I was wondering the same thing too. But I have never been able to keep the weight off for 6 months anyway and what I'll do is just start eating more the last couple of months. Like who isn't gonna gain weight to get it. Its all a game to me. If we could keep it off we would! I don't have the documentaion either so I will have to do that too!

[Mystyblu 0]

I have an appointment to see my PCP next monday. Its just waiting for the 6 months to pass is going to be frustrating.

[Alexandra 55]

That six-month supervised "diet" period is really to make sure you are on board with a regimen and ready/willing to keep followup appointments with your doctor. You'd be surprised how many people find it too big a burden and give up on the whole idea of WLS!

It's not really about losing weight--you can follow your doctor's instructions to the T and you'll probably only lose 20 lbs at the most. Would that be enough to keep you from qualifying? If so, maybe you're one of the borderline people that carriers are trying to screen out. While that may sound callous, look at it from their point of view--they can't simply absorb the costs for every single person who decides they want bariatric surgery. Then need to put some screening procedures in place to be sure they're paying only for the people who are a) really in need of the treatment, and who will use it to their best advantage and be successful.

You're on your way, and 6 months will go by before you know it. Good luck!!

[patticNJ 1]

I have Aetna and started my 6 month diet last week. My PCP sent me to a nutritionist that is on the Aetna plan. Will that still count? I know I won't lose any weight, I've been on WW ans following it to a T and only lost 6 pounds in 24 weeks. My only grip is that the nutritionist cost is $30 co-pay, do I have to pay that every week. I sure hope not, cause that will just go out hte window and I will get RNY which is already approved, but the band needs 6 mo supervised diet.

UGH I hate waiting.

Patti

Newbie.

[aileena 1]

BCBS allowed for WW to be considered a supervised diet. Also my Dr didn't charge for weigh ins.

I only had to go to the nutritionist once.

Good luck! I'm sure it will fly by

[Mystyblu 0]

Thank you Alexandra<O:p</O:p

<O:p

That explanation actually makes sense to me. Now that I know the reasoning behind it I don't hate the idea as badly. If the ins co want to see some dedication I am willing to show it to them. <O:p</O:p<O:p

I am 5'5” @ 245lbs with a BMI of 40.3 and several co-morbidities. I don't think that the loss of about 20lbs is going to knock me off the journey. To look on the bright side of it after the 6 months that will place my surgery in January or February, what a great way to start out the new year.<O:p</O:p

[keri 0]

Hey-

I have Aetna and got approved- with my Dr's note indicating the different "diet" stuff I had done and weight history- I didn't have to wait 6 months- Did you appeal yet? I get my band tommorow!!!!

[Mystyblu 0]

Keri, I called the Dr's office yesterday and the ins co-ordinater said that withouth the 6 months supervision that Atena would 100% deny it but if I wanted she would submit the packet anyway.

Congrats on your surgery date, I will be thinking of you tomorrow. Who is your Dr.??