Got no help in the other forum :( Maybe someone can help here?

ColonelSandurz
on 10/12/10 5:05 am, edited 10/12/10 5:05 am
I made a lengthy post here: http://www.obesityhelp.com/forums/amos/4252658/Looking-for-s ome-info-about-surgery-through-highmark/ 

Not a single person wanted to help me out.  So I guess since I'm in the New Orleans area I could ask here?

I'm going to a seminar tonight about the weight loss surgeries and I was told my insurance requires a 6 month supervised diet by both a doctor and dietitian before they would approve any surgery.  

Now that's my biggest concern over all the questions in that thread above that I made.  I've done many diets before.  Too many to count.  All of them go the exact same way.  I lose 20-30 pounds over about 6 months and then I hit a brick wall.  I went with a  vegetarian/vegan method for a couple of years and actually lost 60 pounds but started gaining them back.  

So I'm worried that if I go through this 6 month waiting period, what's going to happen if I lose weight?  Will they deny the coverage and tell me to do it on my own?  Do people who have to go through this purposely sabotage themselves to jump through the insurance company hoop?  If I have Sleep Apnea is there a way around the 6 month plan?  

What concerns me the most is the copay for those 14 doctor/dietician visits.  It's going to cost about $600 over 6 months just to see these people and if I get declined for the surgery it was just a big waste. 
 What's the matter, Colonel Sandurz? CHICKEN? 
louisianacountrygirl
on 10/12/10 9:38 am - vinton, LA
I am sorry you have not had any responses from the other forums. You will more than likely have to do the 6 month diet. I have not seen anyone who has been able to get past that hurdle. I have also seen that the lose of 20-30 pounds is not going to keep you from going thru with the surgery. Matter of fact my dr is asking that we loose some weight by diet to shrink our liver for surgery. so that it is no so fatty. I know 6 months is a long time to wait but use it to your advantage and get your other test done in the same time frame. I had to see a nutritionist, sleep apnea test ( which you have already done ), behavior psychologist, physical therapist,  get a medical clearance from my regular Dr and a letter of recommendation. So I had a few hurdles I had to go thru. I hope this information helps. I know that insurance policies can differ as do the Dr also. The best thing you can do is talk to someone from your insurance company that knows your particular policy. Good luck in your journey. ...Sherri
                            
materialsguy
on 10/13/10 11:57 am - LA
Sorry....I was private pay.  My insurance would not even consider it.
momgwen5
on 10/25/10 10:46 am - Westlake, LA
I think it depends on your ins company. I have Aetna and they changed it this year to a 3 month deal if it is done through the surgeon and dietician. The dietician and dr visits were covered as part of the surgery. I don't know how I would have been billed if ins would not have approved me for the surgery.
Call your ins company and ask them to send you the requirements or ask where to find the requirements on their website.
        
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