6 month structured diet program

Hi! I have optimum Choice insurance and I am getting a run around and nothing specific from the insurance company on what qualifies as a structured diet plan.  I really can't afford nor do I want to put all the money into Weigh****chers again and Jenny Craig and LA Weight loss are also expensive.  My doctor doesn't have a diet program to give me.  The insurance company did say that what I do has to be documented by my doctor. I'm so confused! Thanks! Kim

Hi Kim: I think....don't quote me on this, but I think a nutritionist will suffice.  You need to start the process, ask them if this is ok....then just follow what the dietician suggests. Good luck, hope this helps!! Steph

Thanks, Steph, Again, I had one person at the insurance company tell me the nutritionist would be covered and another person who said it would not be.  It's making me crazy trying to get straight answers from these people!

I'm in a 6-month diet as well, and my insurance requires that I have a doctor and nutritionist working together to supervise my diet. Insurance covers doctor visits, but not the nutritionist (I pay $40 per visit). As far as working together, my nutritionist just sends her progress notes to my primary doctor each month, and then I weigh in with the doctor. And, of course, they usually give me conflicting information... nutrition says 5-7 servings of grains, doctor says switch to a modified South Beach diet. Nutritionist says get at least 1800 calories, doctor says never eat more than 1500. At long as I keep losing weight, I just do something in the middle.

I can't help you with a recomendation of a diet plan, but make sure you always write down and keep a record of the names and dates of the people you are taliking to at the insurance company. Ask what the insurance company has in writing about the "diet plan" you need to do, and try to request they send that to you also.

What the insurance company is looking for is that you have a diet plan put in place and documented by your physician.  This would include an exercise program as well.  What I did was to meet w/my PCP and go over a suitable program.  For me it included a visit w/my nutri every month and my PCP would document my progress and vitals.  It is important that your BMI, weight, blood pressure and that you were compliant during the month to be documented each month.  Do NOT miss a month or you will have to start all over again.  My diet program was just to eat as if I was already post op.  I did not lose any weight, but I didn't gain either.  The insurance company is looking for structure and commitment on your part. I hope this helps.

An alternative to those weight loss centers is Tops.  While it doesn't have meals that you can purchase they do have a plethora of knowledge and give you MANY tools to keep track of your dieting.  Membership is very cheap at $25 plus what your local chapter fee is (usually 25 cent a week or something..).  Check em out.. Many people have used the tops programs as their diet plan. Tops encourages you to speak to your doctor about your dieting plans and goals.  He can document that you are attending it. 

www.tops.org

There is also overeaters anonymous that could help. I personally don't like the whole spiritual side but some people do.

 

Kim, I also have Opt. Choice. I am almost done with my first month of the 6 month process. My PCP has me on Adipex and I will go in each month for a weigh in.  The surgeon's office told me that my PCP needs to have these items at each weigh in:   1.  Make sure PCP notes your chief complaint is weight management 2.  your current weight 3.  your current BMI 4.  your vitals 5.  what you are doing for the diet 6.  what exercise you are doing 7.  whether you have gained or lost weight I am so stressed about the insurance aspect of this process that I am making my self sick! Opt Choice at first told me that I only needed 3months of 2 different diets and they could be at the same time, surgeon's office called and they told them 6 months!  What the heck?  Please let me know anything that you find out! I live in MD, too what surgeon are you thinking of using? I invite you to join the MD board, it is a great support system. Katherine