Approval w/out diet? ?

Hi I was wondering if anyone has ever been approved for surgery without a supervised diet does it all depend on the insurance company or is it based on your BMI or core morbidities

Yes, people can get approved with no diet. It depends on the insurance and the surgeon.

When I was approved for the lap band ( years ago, my insurance company didn't require anything. And now that I've been approved for the Sleeve revision, they didn't require anything either.

When my PCP wrote the letter recommending the surgery, she did include a statement about all the weight loss programs I'd tried in the past with very little success. So I'm not

sure if that made a difference. But none of those programs were "medically-supervised". But it might be worth asking your doc to include something like that in the letter.

Just my two cents! :) Good Luck!

Th sinsurance company may require the diet before approving. Mine did not - but wanted me to document my prior weight loss attempts.

Some surgeons require a diet prior to surgery to make it easier for their lap tools to work around your liver. Others are more confident in their navigation skills and don't bother.

As Valerie said, insurance companies have a variety of requirements, or not, and surgeons have a variety of requirements, or not. Sometimes they overlap.

Once in a while someone has almost no requirements from either, and get operated on really quick.

Waiting is good. You really, really need time to prepare. If you have to wait, make the best of it. It can really make you more successful.

May I ask what insurance everyone has? I will have aetna.

Which company doesn't matter. Every company writes different policies for different people and employers. One employer with Aetna will choose not to include WLS at all, to keep costs lower. Another Aetna plan will include WLS with no restrictions. Another will have WLS, with a provision it will only cover one surgery per lifetime. Another policy will have a six month supervised diet plan, etc etc.

Have you ever bought car insurance? There are a million options. Do you want broken windshield coverage, roadside assistance, a rental car if yours gets wrecked, coverage if someone hits you, coverage if you hit someone else, and a huge range of amounts and deductibles. The plans that cover the least, cost the least, and vice versa.

Aetna, and every other insurer, will write a different plan for whatever someone wants to spend. The only way to find out what yours covers, is to call them or go online and see what YOUR details are. And whatever they are this year, they will probably change next year.

That wasn't a requirement for my insurance, but they did require a note from my doctor stating that I had been working with her on my weight with little success. She listed out the various things we tried, which did include supervised diet.

Edit to add: I have BCBS of Illinois

I have United Health Care, and all they required was a high enough BMI. My surgeon requires an interview with a dietitian who gets to decide whether to impose any diet and nutrition class requirements. She asked me a bunch of questions about what foods are high in protein and carbohydrates and how I would eat after surgery. I answered them with ease, so she said I only needed to meet the minimum requirements, which consist of one nutrition/mental well being class and a pre-op class right before surgery (to go over risks and sign the consent form). Most people are clueless and have to take several more classes.

You need to call the number on the back of your insurance card or find your benefit plan book. This varies not just by insurance company but by specific plan. Some people with Aetna will have no supervision period at all. Some will have 3 months. Some will have 6. Some will have to lose 10% of their body weight before surgery. Some will have no requirement. Some will only be disqualified if they gain anything during that time.

I had a 6-month supervision period (after waiting 2 years before my insurance would even cover it), and I'm so thankful I did. I lost 80 lbs in that time, made my surgery safer and my recovery easier, and that time was crucial for getting my head in the game. I wouldn't trade it for anything now.