Well I have been denied until I do a 6 month diet

Well all I have been jumping through hoops since March. I decided to send my info to insurance without a 6 month diet (molina of ohio) since I have talked to a few people that also has my insurance that didnt have to and were approved. I guess I will survive I am just sooo mad because I have been working really hard I cut out pop, I have been chewing my food very very very well, I have cut out sugar, and I have been exercising and trying to prepare myself for surgery. It just seems no matter what I do I cannot lose the weight and I guess they need me to prove it to them. I even sent a note showing from the age of 12 years old the different diets, and pills I have been on, and the weight I have lost and yet again gained back. So I guess my 6 months will be up in March. I just hope that I dont do the 6 month diet and then still get turned down. Can they really do that if they tell me I am denied until I do my 6 months? I hope not for my sake and theres I think I might have to hurt someone! LOL

I went through the same thing, thinking I was a shoo in only to find out of the six month requirement.  It will go so quick you won't even know it.  Just keep on with your good habits.  I am glad I had to do it cause it prepared me mentally and physically for surgery.  Just make sure not to miss any of your PCP appts, and get everything documented.  Let me know if you need anything.  Paul from the Insurance board sent me lots of good info to help me and I would be glad to pass it on.  And, yes, the insurance company can deny you for any reason.  If it's in their guidelines, they can deny you.  You can get a lawyer and fight it, but what's six months in the big scheme of things?  You can make it, I know you can.

I would call your insurance and find out for sure EVERYTHIGN THEY WANT FOR YOUR POLICY. Even though 2 people can have the same insurance each POLICY is DIFFERENT . Find out and see what you have to do.   ALSO it says you have to be on a diet it dosen't say you have to lose weight. They want to see an pattern of yo yoing. look at my profile and you can see the 5 year weight histopy I wrote myself for insurance. It's about September 03.
Good Luck,
Robin

I knew before I even had my first appointment with my WL Surgeon that my Insurance required 6 months of dieting. I have read a few times on here that patients are a couple months into the process and then are told they are required the 6 months. I guess every doctors office is different, cause I was called a week before my appointment by my surgeons financial director, and she gave me the heads up. I actually have my first appointment today with the   dietitian  through my surgeons office to get started. I have also been scheduled most of my tests and other appointments already, and as soon as my 6 months is up, I'm done with everything and everything can be submitted to my insurance for approval...I wish you the best hon. Just hang in there and think of this as a good thing. It can only help you get healthier for surgery and help you get a head start on knowing how to eat properly for after surgery!!

yep. each policy is different.  make sure you find out who the diet appts have to be with. 

I had a 6month diet with mine.  sucked but it prepared me.

I am going through my 6 months right now.  I started my process in April.  My surgeon's office actually has a chart showing most insurance carriers they take and each requirement for approval.  I have just followed the chart for Medical Mutual.  I agree with Robin--call the insurance company and get IN WRITING what they require and why they denied you.  Once you complete that you would have a very good position for fighting them should they deny again.  It will go faster than you think.  I was thinking the other day that it feels like I've been doing this forever but my hopeful date of surgery is really only 3 months away!!   Hang in there and you'll be there in no time!!

Good luck!

I'm in my 2nd month now... I've lost 9 whole pounds (whoopie)
I will say I was a bith p/o that in the past 2 weeks I've stayed the same weight.. all that healthy eating, carrots, tuna, no chocolate, no mcdonalds, no soda, no cookies, no cake, no chocolate chip ice cream... and what... I stayed the same.  Heck I even went to Golden Corral the other night and ate salad.    (Honestly, the food there made me sick.  Back in the day that place was awesome.. now I look at it like O M G.. I used to eat that stuff??)

You'd think that someone who was 50+ BMI wouldnt need yet another failed attempt diet... but oh well.. I'll do what it takes.  I am learning to look at everything that goes in my mouth.. that's a good thing... can't believe some of the #$%#$% I used to eat.


Hey Robin!  How are you doing???   can you forward the insurance info you have on to me?  I'll add it to my list.

Will my weigh****cher weight loss card be enough for insurance (on top of my doctors report) or do they want a copy of my journals?   I really hope not.. my journals are so messy!!

(ps.. support meeting tomorrow night at sycamore)

Hey Tony, I am planning on coming tomorrow to Sycamore.  Remind me and give  me your email address tomorrow and I can forward that stuff over to you.  See ya

I am on my 4th month of 6 months of the medically supervised weight loss diet. My insurance company buckeye medicaid keeps telling me that there is no specific amount of supervised diet needed, but my doctors office who is going to perform the surgery keeps telling me that I need 6 months. My fear as well, is doing this 6 months driving from Toledo Ohio to Bowling Green and still being denied for surgery at the end. Ive passed my psych. test, and Ive been cleared for surgery through a medical doctor who order everything from EKG's to Xrays to blood work and everything is all set to go except for this 6 month diet. I have been dieting all my life and I am jut tired....

Does anyone know anything about the Buckeye Insurance (Ohio medicaid) steps to getting approved for Gastric Bypass Surgery??? Please let me know

Yeah I called molina and they (3 diff. people) told me no there is no 6 month diet, but I got my denial letter today and it said I didnt have me 6 month supervised diet. I started journaling my food logs in Aug. on the 14th so I guess I am going from August 16th. I am driving quite a ways as well from marysville to Dayton which is a hour and a half drive. I am done with everything too except the 6 month diet. I also have to get a pulmonary evailuation, and I am confused about that because I went for my sleep study and I do have sleep apnea. I was thinking that was my pulmanary evailuation guess not I need to find out what the hell it is. Yeah I have been dieting since I was 10 years old maybe earlier. I even sent them a letter explaining my failed diet attempts the years my age, what diet I was on the pills I have tried and when, and of course they need to actually see me fail. My fear is getting bigger because I am trying not too which always brings on the lbs, and then being denied. My problem is I never feel full that is why I need this surgery so that I will feel full. Instead of feeling full I just eat until I feel sick. I hope and pray everyday I am not doing all of this for nothing I mean damn if I thought I could do this on my own I would I sure would not being putting myself at risk. Oh well I am going to continue so that skinny son of a b*tch who denied me can deal with me again. I am sad and pissed off all at the same time...... But good luck and dont give up make those s o b"s do there jobs.