Doctor supervised diet

rroswelltx · 01-10-2006, 12:01 PM

:help:
Ok I go to the doctor on the the 20th to get the insurance stuff turned in. Some of you know my story about trying to get approved last year and what the barix clinic drama was. Ok so I digress. I know that I can possibly be denied again this year with my new insurance which is Aetna. They are going to want me to go on a doctor supervised diet, which I am actually on right now to get a head start. My question is this, I know I can loose weight on a 1200 calorie diet, but I am unable to maintain that indefinetly, and it comes right back plus. If I loose weight on this diet and my BMI drops below 40 won't the insurance company then say, well if you can loose weight on your own you don't need surgery? Isn't it a double edged sword. Or do I do the diet but not really and not loose weight. I don't want to do the dang yo/yo stuff anymore. Any thoughts? :faint:

rroswelltx · 01-11-2006, 10:28 AM

Ok I'm confused, hasn't anyone been required to go on a doctor supervised diet for insurance approval??? No one is responding to how they handled it, I'm feeling very unloved here

Please some encouragement from my favorite board!!!

LSasha · 01-11-2006, 11:09 AM

I have no exerience w/Aetna but my surgical coordinator told me that Aetna was the hardest to get approval from.

I also did a 6mth supervised diet. I was concerned in the beginning about losing too much, but my insurance will approve w/a BMI of 40+ or BMI of 35+ w/2 documented co-morbities, which I had. So I was kind of, sort of safe

MyKdsDad · 01-11-2006, 03:31 PM

Regina, that is what the insurance lady at the doctor's office said that my wife would have to do. However, with a BMI over 50 and a good strong letter of necessity from her doctor she was approved by BCBS in about two weeks. No supervised dieting at all.

Poodles · 01-14-2006, 11:03 PM

I am currently doing the supervised diet game too. Four months officially gone now. I have literally tried. I would recommend that you do what you can, show some progress if you can, but try to stay above 40 bmi just in case. A little head start on the band would help anyone. :) Good luck.

Cheri · 01-15-2006, 12:55 PM

Hey~

I know this is definitely not what you want to hear, but here goes (you want the truth, right?)

I started the journey for bypass, got all of the info for getting insurance to cover it, blah blah blah. The six month supervised program is a big fat sham IMHO! Anyone can lose weight by dieting, ANYONE, but we few and proud cannot keep it off after losing it! The insurance companies know this, but they sure do save a bunch of money at the time. What about down the road? They really should wake up! Sorry, hit a sore spot!

The person I talked to at my insurance company said that I would probably never be accepted for weight loss surgery - BCBS alabama does not cover lap band under any circumstance, and the six month supervised diet would put me under (albeit temporarily) the BMI requirement for bypass!! She understood my frustration, but was brutally honest. I am glad she talked to me, because I wasted no more time pursuing that path!

So, here I am, happily banded (4 month process from start to band), with a huge sum of money financed for the rest of my life! But Hey, I'll have a longer life to pay it off!!

Don't give up, but please please please be sure you know everything about your insurance carrier! Six months is a long time, and I would hate for you to get at the end of it and they tell you, "oh, well this is what the insurance plan states, sorry about your luck!" Just be very educated.

My biggest piece of advice is to talk to the billing person at your surgeon's office - he or she will be a library of knowledge to you!!!

~cheri