Insurance Approval Anxiety.... HELP I gained 10 lbs.

Hi my name is Brandy. I am looking forward to getting approved for weight loss surgery. Tomorrow is my last day of 90 days medically supervised diet. I have United Health Care HPN so I was required to see a nutritionist for 90 days at the Health and Wellness (HEW) Class. I have a lot of anxiety because I have actually gained roughly 10 bs. in 3 months. My final weigh in with HEW is tomorrow. I feel sick that I may be denied. I am reaching out to anyone to see if you have any knowledge... will this affect me being approved. If I lose the 10 lbs. prior to submission to insurance will I be approved? Any insight would be greatly appreciated. 

If you had a medically supervised diet and you gained weight, there is a chance you will be denied. Insurance wants to see that you've made an effort to lose weight on your own and have been successful. My surgeon wouldn't have operated either, had I gained weight. He's pretty hard core like that. Maybe you can "redo" your 3 months and THEN submit?

Thank u so much. Today is the final exam as far as health and wellness go.

Hi Brandy -

I was on a 12 month medically supervised diet and ultimately gained 15 pounds.

And I was still approved by my insurance (BCBS-KS) for WLS.

Wishing you good luck on your approval process!

Awesome that is great news! I have not met the surgeon yet. I am hoping I will lose during pre-op diet and be deemed worthy... thank you!

Every insurance plan is different in regards to pre-op diet expectations. Some need you to lose, some need you to lose but not below a certain threshold, others just require that you do it at all.

Find the phone number on the back of your insurance card, call customer service, and ask what their criteria are.

ok great idea thank you so much I was advised I did not have to lose anything but I am pretty sure I was not supposed to gain any

LOL....I know someone who lost too much weight during their six month physician supervised weight loss plan.  At his final weigh in he had two scuba diving weight belts on under his shirt so he'd weigh enough to get approved for surgery.

Hi, Brandy,

As the others have said, it depends on your insurance policy. My policy doesn't detail any weight loss needed during the six months. Yours could be different. I would just call them to be sure.

Thank you so much. I will call patient advocate and see.