Pre surgery diet Q

*linda* J.
on 11/29/04 4:52 am - belmar, nj
Hey everyone, I read in my insurance packet in order to approve WLS I must have completed a six month supervised diet. I am curious about whether anyone has lost weight on these diets and do insurance companies deny the surgery if weight is lost? Thank you in advance for any info. love, linda
DJ
on 11/29/04 7:11 am - Parsippany, NJ
I've been wondering the same thing.. I hope someone answers this. .
SAVAGE
on 11/29/04 9:09 am - Howell, NJ
Linda, i have heard ins comapnies like Atena do require this. I have seen where others join weigh****chers and go to the dietician your doc will refere you for a consult anyway as it is poart of the process. Any medical records like going to the doctor each time they weigh you if the doc put you on a doet ect. the med charts are great because it has a history of your weight and shows it over the period of time you have seen the doctor. So check with your doc and call the insurance co and sometimes the doc doing the WLS will puiut you on a diet to see if you can actually stay on a diet and do what is required pre and post op. good luck joyce
Susan Hegarty
on 11/29/04 11:17 am - Easton, PA
Hi Linda I had to do 2 of the dreaded 26 week "medically" supervised diets for Cigna. I did lose weight and also gained it back. Some insurances want to see if you are capable of losing weight with behavior modification, increased exercise, nutritional counseling and reduced caloric intake. Cigna did NOT accept weigh****chers, nutri-system, etc. It had to be supervised by a doctor. I have never heard of anyone being denied not losing enough or gaining too much while on the diet. Best of luck to you in beginning your journey Susan LAP RNY 11/24/04 -17 lbs.
*linda* J.
on 11/29/04 7:09 pm - belmar, nj
Thank you to all *****plied!! Yep. it makes sense now! I guess the insurance company (Aetna) just wants to be sure I have attempted dieting. I read the requirements and I need to have completed a 6 month supervised diet. I am assuming it means recently? I do have 6 months in from about 1.5 years ago, lost 70 pounds on Atkins. 70 pounds which I have gained back! Wishing everyone a healthy and happy day! Jeez, its chilly this morning!
*linda* J.
on 11/30/04 7:42 am - belmar, nj
I found out today as of Jan 1st, my insurance company, Aetna, will no longer be covering WLS. Very disappointed as I have made an appointment with a surgeon and finally felt very comfortable with my decision to have the surgery. Good luck to all who have had/ are waiting for WLS. This is a wonderful community board and I have enjoyed it! love, linda
Steven J.
on 12/2/04 8:32 am - Gibbstown, NJ
I have Aetna insurance. I had a surgery date of 12/6/2004. I was denied my operation after having it scheduled since July. I have gone through all of the pre-surgeical tests since September only to find out three weeks before my surgey date that Aetna has denied coverage. The reason given was that I didn't participate in a three month, medically supervised diet and excersize program withing the last two years prior to the surgery. If they would only tell you this prior to having all of the tests then they could have saved themselves as well as me precious time and money. How stupid are these insurance companies. If dieting really worked, then I wouldn't have ever considered risking my life to go through the operation in the first place. I have been on diets almsot my entire adult life. And to think that the shrink that did my psych evaluation said that I was well adjusted, rational and well informed of the risks. He should evaluate me now. I am so angry I want to through something through the monitor. Well, have a nice day!
*linda* J.
on 12/2/04 10:09 am - belmar, nj
NO NO!! Not the computer! I sent you an email but, will post it here! I think you should appeal Aetna's decision based on you weren't given the 6 month diet info. Since you were denied before the cut off date I think you'll be okay. Try to stretch out the appeal so you get 6 months of supervised dieting in! Kind of jealous now! wish I had an appeal! Good luck to you! love, linda
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