medicare precert diet question

i'm curious. my BMI is 40.9. so im hovering on qualifying for my RNY through medicare/medicaid. i just started the sixth month precert diet. what if i lose 20 or so pounds in six months? i want to follow the diet so i can prove that i can follow the post op diet. but, my BMI will drop, will i still be able to get surgery? i Am able to lose weight. it's just, i dont stick with it for more than a month or two. i'm using fit day and today i've had less than 800 calories. those atkins advantage shakes are actually satisfying. i asked my dr if i'd still qualify to get surgery if i lost weight and all he said was "lets not think like that." anyone else went through this with medicare? thankyou.

i did a 6 month certified diet showing that i could NOT lose the weight when i was going for medicare/medicaid but they didn't do precertification at that time, i had to sign my life away stating i'd pay for it if medicare didn't pay after the fact. turns out they found an umbilical hernia during surgery and billed medicare for that instead of the WLS so i dodged a bullet. i'm not sure what would've happened if they billed for the WLS.

wow, yeah! that's great you didnt have to pay for it. i couldn't imagine. i'd be in debt for the rest of my life.. that's crazy about the hernia. there's so many mentions of hernias on this site. why are they so common? so do u suggest that i should Not lose weight? i just want to do the right thing. i can lose weight drinking 3 shakes a day and exercising. but i cant do That for the rest of my life. i really want my RNY. i need it. i dont wanna give my dr the false impression that i dont need it. i'm just not sure what they want.

i really can't suggest anything, you need to talk to your surgeon and find out what they thing and if you don't trust his opinion, find another surgeon. i was lucky to have one *****ally wanted to help me, who i could trust 100%.

i don't know how common they are pre-surgery as my first one was but that was something caused at birth (according to what i've read) and it just never caused me a problem so no one ever knew about it. After surgery i think it's got to do with the fact that our muscles have been cut (especially those who had open surgery) so it's easier for parts of our intestines to find an opening and squeeze through them. also our guts have been moved around and twisted and such. don't quote me on that though, i haven't really looked into it, it's just my understanding from the bits i've read here and there on the boards. i think i got three more hernias yesterday cause when i saw KP put on the rubber gloves my intestines shriveled up and hid anywhere they could! (he just put them on cause he helped drain my jp tube but it was pretty funny watching him, that guy cracks me up. and it amazes me how much help he is willing to give all of us, he's like the OH big brother or maybe good fairy is a better name lol.)

Sarah: Have you been over to the Insurance Message board? They have a lot of knowledgeable and helpful folks over there. I'd also suggest getting the exact criteria that Medicare requires for approval of the surgery. Many insurances do an either-or thing. BMI over 40 OR 35 and up with co-morbs. So you may still qualify if your BMI is under 40... just need to check on the details. You're in Flint. Are you going through Hurley? When I registered there, they gave me an insurance packet that listed the criteria in detail about what my particular insurance requires. So I'm sure they've got the same thing for Medicare. HTH Pam