6 Month Diet Before Approval

[SmartSassyChick 0]

Hi Everyone!

I'm about one week new around here. I meet all of my insurance requirements EXCEPT that I haven't been on a physician supervised diet for at least 6 months during the past 2 years. I've been on plenty of physician supervised diets in my life, but I know they won't work (long term), so I haven't wasted my time or money in the past two years. I'm very unclear as to what happens after I finish the 6 months...do I have to fail and gain all the weight back? I've called my insurance company, but have talked to several people who can't answer the "then, what?" question for me. Has anyone else had to get past this hurdle? :sad:

[HolliJ 24]

I was wondering the same thing when I initially looked into the lapband and would like to know the answer.

Luckily my insurance company isn't requiring the 6-month diet, so I didn't have to look that far into it.

It seems like if you lose weight, that would take your BMI down and you can't have the surgery. Most of us would absolutely absolutely gain it back. And if you don't lose weight and keep your BMI the same, you're just wasting 6 months. I just don't understand why the insurance company requires this. It's stupid, IMO.

[KarissaLynn 0]

I'm new too and I've heard that my insurance requires the 6-month diet. I have to wait until Monday to ask them for sure...I really don't want to wait 6+ months but I don't see any other way. I'm an unemployed student so I can't self pay :biggrin:

Edited June 21, 2009 by KarissaLynn

[HolliJ 24]

I'm new too and I've heard that my insurance requires the 6-month diet. I have to wait until Monday to ask them for sure...I really don't want to wait 6+ months but I don't see any other way. I'm an unemployed student so I can't self pay

Well, I work full-time, work part-time (second job), and go to school part time... and I STILL can't self-pay.

[krysimarie04 0]

I am also doing the 6 month diet. I asked my surgeon the same question because I BARELY qualify (BMI 40.5) and I don't want to go down and be denied... he said it's just to prove that you are able to make the lifestyle change and to get yourself as healthy as possible for the surgery to reduce the risk of any complications. When the submit the packet to your insurance, they submit the weight and BMI that qualified you in the beginning, NOT your weight 6 months after. It's also supposed to help shrink your liver so they don't have to try and work around it as much during surgery.

[HolliJ 24]

I am also doing the 6 month diet. I asked my surgeon the same question because I BARELY qualify (BMI 40.5) and I don't want to go down and be denied... he said it's just to prove that you are able to make the lifestyle change and to get yourself as healthy as possible for the surgery to reduce the risk of any complications. When the submit the packet to your insurance, they submit the weight and BMI that qualified you in the beginning, NOT your weight 6 months after. It's also supposed to help shrink your liver so they don't have to try and work around it as much during surgery.

Oh, sweet, good deal. I was wondering how that worked.

I think I'm going to call my surgeon's office tomorrow and ask them if it's ok for me to get a head start on the weight loss, pre-banding.

[maclynn 0]

When I started my 6 month insurance required physcian supervised diet and exercise program my BMI was 43.2. After initially losing 18# my BMI was 39.5 and I was very worried that my insurance company would now deny me as I was no longer 40+ BMI. To my happy surprise, they did approve me after all was completed. I hope that your insurance company follows the same guidelines since I was getting conflicting information such as they go by your hightest BMI but I cannot tell you that is a fact. Best of luck to you.

[SmartSassyChick 0]

Thanks everyone for your responses, it's been very helpful. It may be a moot point though, because after doing some more research, I'm starting to lean toward the sleeve rather than the band. The sleeve isn't covered by my insurance though, which would make me self-pay :blushing:. So, I have to decide if I should try the band because my insurance will pay for it, or pay for the sleeve myself because I think it is a better choice for me overall. Decisions, decisions...

Good luck to all of you!

[dedumplinz 0]

hello there i just finish my 6 months diet. just got aproved today. but doc called and told me that i will have to wait until she finds out if lapband is right for me . i have been haveing gi problems. i dont know what the problem could be ,i was so close to geting my band now i have to wait allittle longer. they told me that they will have a meeting first week of july. hope all goes well.

[HolliJ 24]

Thanks everyone for your responses, it's been very helpful. It may be a moot point though, because after doing some more research, I'm starting to lean toward the sleeve rather than the band. The sleeve isn't covered by my insurance though, which would make me self-pay :blushing:. So, I have to decide if I should try the band because my insurance will pay for it, or pay for the sleeve myself because I think it is a better choice for me overall. Decisions, decisions...

Good luck to all of you!

If it were me and I had the choice (both being covered or both being self-pay), I'd choose the sleeve. Unfortunately the band is covered by insurance and the sleeve is not. I can't afford the self-pay, so I'm going with the band. I'm sure it will work great for me. If something goes wrong in the future and it has to be removed, I might end up getting the sleeve.