3 Month Pre-Surgery Program Question

I have Aetna insurance and was wondering for those of you who have insurance that requires the 3 month multidisciplinary prepatory program, how much weight did you lose in those 3 months? I was told by the hospital that there wasn't a minimum. But I am worried what if I don't lose any or not enough, will insurance deny me or extend it? What has your experiences been? I would like to know if anyones was extended or did anyone actually gain weight and still get approved, or how much did you lose? I would appreciate feedback. I am only 3ish weeks into the 12 weeks so I have plenty of time. Thanks!

Lisa We all get asked this question ALOT... They consider your starting weight. Therefore, make sure your primary care physician has it documented... go see him right before you begin the 3 mo program, get weighed, and also have him document your bmi (body mass index). I started out with a bmi of 43. I was scared, what if I got down under 40, which my insurance made it mandatory to be 40 if there were no comorbidities.... But it wasnt that at all... Most here can say the same thing. The insurance company wants to make sure you are committed to losing weight, and also hoping that when you go on your 3 mos, you will lose a lot and decide not to have surgery, which normally isn't the case. Many peoplle know they only gain back what was lost... gain, lose, gain , lose... vicious cycle... but your insurance company can always HOPE! Good luck

If your insurance company didn't state a certain amount you have to lose, it doesn't matter if you lose anything or not as long as you complete the 3 month program. My insurance company has now changed their requirements and require a loss of 10% of the starting weight. When I had my surgery, they just required proof of at least 6 months of monitored weight loss attempts. Just remember, the more you can lose prior to surgery, the easier your surgery will be. I'm glad you found the site so quickly. Welcome to the group!! I sure hope you will be able to join us for lunch on the 19th. We will be meeting at Red Lobster in Cool Springs at 1pm. I'll post a reminder with more details (directions, etc.) the week leading up to the 19th. Susan

Hi Lisa, I too have Aetna open access and went through the 3 month prep as well. I more or less stayed the same and at my last visit I had gained about 4 pounds. I was told that they use your first weigh in to send to Aetna. My starting BMI was 42 and now it's 43. I was told if my BMI dropped below 40 that I wouldn't get approved. I made sure that didn't happen. I was approved in less than 2 weeks with Aetna. I go in today for my pre-op visit and get my date, yea! They want you to get in the habit of getting in your protein first then vegetables followed by your grains. They also want you to get used to not drinking with your meals. I followed the rules in the beginning, but then the closer I got to the end of my 3 months I started eating things that I decided that I would leave alone after my surgery and therefore gained the 4 pounds. Hope this helps, let me know if you have any other questions.