I'm nervous about getting approved by insurance

Hi there. I'm looking into getting gastric bypass surgery. I have horizon nj health insurance and I called them about the requirements.

They said the following -

Must have medical records of me bing on a 12 month weight-loss program

Must be considered morbidly obese

Must go through a psychological examination

Must get approval from the surgeon

The first one worries me the most because I havent been to the drs in a while and definitely have not be on a weight loss program. I have attempted to lose weight and lost a few pounds by changing my diet around but that was just a personal thing.

The insurance operator said that it could be overlooked if the doctor feels like I really need the surgery.

How do I convince my doctor that I don't need that part? I have a medical condition that is worsen by my weight so should I bring that up? How do I go about it when I see them on the 6th of June?

If you have my insurance and had to go through this, were you able to have it overlooked?

Im pre-op as well, and my insurance has a 6 month diet requirement which I recently just started. (I go to a dr appt once a month to be weighed in)

Definatly speak with your dr about this, I would just explain your ins situation and see what they say.

That being said, i dont think a pre op diet is a bad thing. It gives us a chance to get our healthy lifestyle going...

Good luck!

Following that twelve month diet properly will give you much of the same benefits as having surgery. Before surgery, I was on a diet and exercise program, not supervised, that resulted in twelve pounds of loss.

That was one thing that really convinced me that I needed surgery.

When I did a three month program, I had gained back the twelve pounds. I also lost a pound a month with the physician supervised plan. A year sounds like a long time now, but it is nothing compared with the lifetime of changes that you need to make.

My physician supervised plan was to eat no white carbs, no caffeine, and exercise at least 20 minutes daily. By the time I had surgery, I was used to those rules and did not have to go through carb or caffeine withdrawal.

My advise is to start the required plan now.

Find a surgeon/hospital that your insurance accepts. Talk to them and at the very least get the process started.

Usually these surgeons have coordinators that are familiar with the approval process. They're an enormous help.