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  823 People Lost in total 72240 lbs = 29.01 % Give us permission to add your before & after Weight Loss Photos |   |
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07-09-2007, 04:35 PM
| #1 (permalink) |
| Whipper Snapper  Join Date: Jul 2007 Location: Hagerstown, MD
Posts: 42
Weight Statistics July 11, 2007 Start Date:
April 15, 2008 Surgery Date:
5' 4"
Height:
315 lb Start Weight:
254 lb Current Weight:
150 lb Goal Weight:
61 lb Weight Loss:
104 lb Lb Left to Lose:
19.3650793651 % % Lost:
Body Mass Index 54.0637207031 BMI Start:
43.5942382812 BMI Current:
25.7446289062 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass |  Structured Diet Programs Okay, so I talked to my insurance company today to get the lowdown on what is needed to be approved for surgery. My insurance company does cover the surgery, but one of the pre-requisites is that I need written documentation of one structured diet program in six months or two structured diet programs in three months. I'm a little confused....do I need to go and join weight watchers now??? I did it like six years ago, but I haven't done anything like that since. Or written documentation of a diet that my doctor would have placed me on and my doc has never done that. Is that what I need to do for the six months before surgery?? And then what are the guidelines? If I lose weight on it, will they not approve surgery?
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Yes, you can often get insurance cover for your Weight Loss Surgery. Our own Craig "Big-T" Thompson has been there and done that, and he's written an e-book about it.  |
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07-09-2007, 04:48 PM
| #2 (permalink) |
| Seasoned Veteran  Join Date: Jan 2006 Location: SOMEPLACE LONG ISLAND, NY
Posts: 6,756
Weight Statistics June 1, 2005 Start Date:
Height: 310 lb Start Weight:
167 lb Current Weight:
159 lb Goal Weight:
143 lb Weight Loss:
8 lb Lb Left to Lose:
46.1290322581 % % Lost:
Body Mass Index 51 BMI Start:
27 BMI Current:
Weight Loss Method Roux en Y Gastric Bypass     |
((HUG))) sorry you have to go thru this. I am sure others that had to go thru six month supervised diets can give you the lo down. I didnt have to do that but i hear my insurance is now starting that requirement as are many!
__________________ LISA  http://w5.photobucket.com/widgets/dy...164/fr1endly2/ LAP RNY Gastric Bypass  |
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07-09-2007, 07:02 PM
| #3 (permalink) |
| Seasoned Veteran Join Date: Apr 2007 Location: Mount Vernon, NY
Posts: 7,902
Weight Statistics all my life Start Date:
4/19/2007 Surgery Date:
5' 9"
Height:
260 lb Start Weight:
149 lb Current Weight:
160 lb Goal Weight:
111 lb Weight Loss:
-11 lb Lb Left to Lose:
42.6923076923 % % Lost:
Body Mass Index 38.3910943079 BMI Start:
22.0010501995 BMI Current:
23.6252888049 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass |
oh man! im sorry you're having this bump in the road. I wasnt required either so I'm sorry i cant help. Just passing thru to lend some support.
__________________ Anything worth having is worth working for!   KenyaR.  Lap RNY 4/19/07 |
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07-10-2007, 08:13 AM
| #4 (permalink) |
| WLS Master Guru  Join Date: Apr 2007 Location: Central Virginia
Posts: 670
Weight Statistics 4/30/2007 Start Date:
9/5/07 Surgery Date:
5' 4"
Height:
233 lb Start Weight:
134 lb Current Weight:
140 lb Goal Weight:
99 lb Weight Loss:
-6 lb Lb Left to Lose:
42.4892703863 % % Lost:
Nov 2008 Goal Date:
Body Mass Index 39.9899902344 BMI Start:
22.9985351562 BMI Current:
24.0283203125 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass |
It sounds like BC/BS. They've got the same line in my policy. My PCP sent them a letter saying I've been on many structured diets while under his care since 1997. I'm waiting to see if that's enough because my last successful weight loss/structured diet was in 2002-2003. I'll let you know if I hear.
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07-10-2007, 08:36 AM
| #5 (permalink) |
| Seasoned Veteran Join Date: Jan 2006 Location: SOMEPLACE LONG ISLAND, NY
Posts: 6,756
Weight Statistics June 1, 2005 Start Date:
Height: 310 lb Start Weight:
167 lb Current Weight:
159 lb Goal Weight:
143 lb Weight Loss:
8 lb Lb Left to Lose:
46.1290322581 % % Lost:
Body Mass Index 51 BMI Start:
27 BMI Current:
Weight Loss Method Roux en Y Gastric Bypass |
I had the BS/BC ppo ..... i know they have added this. I know my PCP wrote a letter ot my surgeon for part of the package but im clueless what it said. I am sure it has said i been under his care for years trying numerous diets.....not sure. BE strong you will get thru this obstacle!
__________________ LISA http://w5.photobucket.com/widgets/dy...164/fr1endly2/ LAP RNY Gastric Bypass |
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07-10-2007, 10:31 AM
| #6 (permalink) |
| Whipper Snapper Join Date: Jul 2007 Location: Pittsburgh, PA
Posts: 30
Weight Statistics Jan. 4, 2008 Surgery Date:
5' 4"
Height:
278 lb Start Weight:
230 lb Current Weight:
140 lb Goal Weight:
48 lb Weight Loss:
90 lb Lb Left to Lose:
17.2661870504 % % Lost:
January 2009 Goal Date:
Body Mass Index 47.7133789062 BMI Start:
39.4750976562 BMI Current:
24.0283203125 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass |
KnitterGirl, I have Highmark PPO Blue--not sure what you have. It requires a CONSECUTIVE 6 month physician monitored diet program--mine cannot be broken up 3 months and 3 months. It is also required that this 6 month diet be within the last 2 years. Beside the diet they require a consultation with a nutritionist and a consultation with a phsychiatrist. When we (my husband and I) met with out doctor the recommended a 6 month diet program that they offered so that is what we are now going thru. They said you could use your own PCP for this, but I knew that my PCP wouldnt go for WLS. So my husband and I decided to just do the diet program together--we already knew insurance accepted this program as the doctor had told us that many of her patients have went through this same program. And the people running the program are working with my doctor so they are actually teaching you want will be needed after surgery as well--not just a diet--a new lifestyle. Hope this helps Beth
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07-10-2007, 04:47 PM
| #7 (permalink) |
| WLS Master Guru  Join Date: Apr 2007 Location: Near St. Louis, MO.
Posts: 953
Weight Statistics 04/17/2007 Start Date:
April 30, 2007 Surgery Date:
5' 5"
Height:
296 lb Start Weight:
160 lb Current Weight:
150 lb Goal Weight:
136 lb Weight Loss:
10 lb Lb Left to Lose:
45.9459459459 % % Lost:
05/21/2008 Goal Date:
Body Mass Index 49.2515976331 BMI Start:
26.6224852071 BMI Current:
24.9585798817 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass |
I have BC/BS of CA and they didn't require me to have one either. Reading all of the problems that people have had has REALLY showed me how lucky I was in all of this.
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07-10-2007, 05:52 PM
| #8 (permalink) | |
| Big Loser  Join Date: May 2007 Location: Florida
Posts: 196
Weight Statistics June 5, 2007 Start Date:
July 31, 2007 Surgery Date:
3' 0"
Height:
260 lb Start Weight:
160 lb Current Weight:
150 lb Goal Weight:
100 lb Weight Loss:
10 lb Lb Left to Lose:
38.4615384615 % % Lost:
Dec 2008 Goal Date:
Body Mass Index 141.033950617 BMI Start:
86.7901234568 BMI Current:
81.3657407407 BMI Goal:
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07-10-2007, 06:00 PM
| #9 (permalink) |
| Seasoned Veteran  Join Date: Aug 2006 Location: WADING RIVER (Long Island), NY
Posts: 5,018
Weight Statistics 7/16/07 Start Date:
7/16/07 Surgery Date:
4' 11"
Height:
230 lb Start Weight:
130 lb Current Weight:
115 lb Goal Weight:
100 lb Weight Loss:
15 lb Lb Left to Lose:
43.4782608696 % % Lost:
12/31/08 Goal Date:
Body Mass Index 46.4492961793 BMI Start:
26.2539500144 BMI Current:
23.2246480896 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass |
HI I ALSO HAVE BC/BS THEY DID REQUIRE THIS 6 MONTH DIET BUT MY PCP WROTE THEM A LETTER SAYING I HAVE BEEN UNDER HIS CARE FOR YEARS AND HAD FAILED DIETS AND EXCERCISE PROGRAMS AND THAT ITS GETTING HARDER FOR ME TO EXCERCISE SINCE IM STARTING TO HAVE PAIN IN THE HEELS OF MY FEET DUE TO MY WEIGHT. ( iwas never under an actual diet under his care but he wrote this for me.) HE ALSO SUPPLIED THEM WITH PROOF OF A MEMBERSHIP TO A GYM I WAS PART OF 2 YEARS AGO WHICH SHOW MY ATTENDANCE TO THE GYM (figured it would help). SORRY YOU HAVE TO GO THRU THIS BUT THE 6 MONTHS WILL HOPEFULLY FLY BY 
__________________ 3/2008 PREG. START WT 144LBS. GOAL WILL HAVE TO WAIT TILL AFTER BABY  230 lbs 7/2007 & 142 lbs 4/2008     |
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