I have Aetna and I am nervous about one part of the clinical bulletin...The 24 months documented weights. I have been obese my entire adult life and in 2009 my doctor advised me to lose weight. Well, I did. But an injury in 2011, caused me to be unable to workout for a while...you know the rest...Here I am today, I gained it all back plus 13 pounds! In 2011, my bmi was below 40 (37.4 to be exact). I have no comorbidities that I know of (sleep study is next week). I am currently at BMI of 43 or so. Anyone, have this issue? I am gathering weights back to 2006 to show I didn't just become obese lately. Oddly, one of the requirements is that you actually had to try to lose weight and be unsuccessful. *Sigh* This is so frustrating! Any advice is welcome!!!

I am also having surgery with Dr. Macik...I was told to get someone to bump up my 2011 weight...(its 14 pounds low, but I was also hospitalized at the time). No one will do that, seeing as its kind of insurance fraud! We can't send in for approval until 9/5/13 waiting for 90 day program to be complete.

 

I have completed all the requirements needed for surgeon and insurance on July 19, 2013. T he nurse explained that the endoscopy does not effect my paperwork being sent n 2 insurance. Still to date my patient advocate Angela has not sent them n2 insurance for approval. When called on 8/9 she didnt even have my file think nurse still has it plus she was telling me the other tests I need for my insurance. The point is the tests she told me I already had only thing left is send off for aporoval. My question is has anyone used DePaul WL Ctr and had any issues with approval taking forever? I'm thinkin about call Barnes for transfer just trying to hang n there because been at it 6 months going in 7.

Hey everyone! I'm starting the journey to be approved by my insurance (Healthy U Medicaid) for gastric bypass. 

 

I found the requirements online through the state Medicaid website and I'm just looking for a little clarification. I know some insurance require documented diet plan for 6 months, but this is what mine states:

The medical record must document, with a supervised weight reduction program, a body weight loss of at least 10% within the six months prior to the request for bariatric surgery   I am 5'10 and weigh 311, does this mean I have to lose 30lbs before I can be approved? Do I have to diet for a certain amount of time or is it just as soon as I lose the weight within the six months prior. I also HAVE to have a bmi of at least 40 to qualify. If I lose 30lbs, I will be right at the edge and I'm afraid I will not qualify. 

Any info is appreciated! 

Def doing this. I'm calling HR on Monday to see what all they can send me on the requirements. I know it varies so much, even from state to state, plan and of course companies providing your plan.

Thanks )

Have you been to a doctor at all prior to five years? If so, make sure those records get sent to the place you want to have surgery. They should be able to help you do this.  Have you attended a weight loss surgery seminar with the center? If not look into one. They are free, and will answer questions and help you get everything you need to do to get what you need to get insurance approval. 

Good luck!