Question:
why is it going to take so long?
i'm doing all the initiual testing, but i don't understand why i may have to wait 6months before the ins will aprove me for surgery, aleast that what the ditetican told me, i have all the co-morb. that will qualifiy me,so what is the hold up? — peace (posted on December 11, 2005)
December 11, 2005
Your health insurance carrier may have a clause in the policy.Some
insurance companies whats a supervised diet for six months. Check with your
insurance company.
— lkirkland1
December 11, 2005
I'm about to be going myself to see the Dr. for the first time, but I
understand the company I've taken for my medicare choice plan is Humana and
that they approve in as little as 9 days for surgury approval. Hopefully
since I've done all my testing thru my local physicans who are in support
of RNY by pass surgury. I know I have to have 3 years of weights either
thru the physican I am using or one I have used for weight loss. Also you
have to have a thyroid study which I'm already on synthroid. Cholesterol,
Sleep Study where indicated. I've had a heart catherization related to
knee surgury this past year. I know that came up in the phone interview I
had with the Nurse. Also recommendation from your physican I know if none
testing has been done it will have to be done. I'm going myself January
2nd to meet my hopefully doctor. I've done alot of research on this
website about foods other problems people are talking about. I hope this
helps. Some of the stuff I know since I'm also a nurse and used to help
file medical claims.
— Deborah Joyner
December 11, 2005
Martha, my health insurance CIGNA PPO has a 6 month requirement and that is
you are under the supervision of a physician and involved in some type of
weight loss program -- monitored by my physician.
— the7thdean
December 11, 2005
I think that maybe you should contact your insurance company yourself and
find out directly from them why there is going to be so long of a wait.
Also, contact your surgeon.
Melissa
— kizie23
December 11, 2005
I looked at your profile and you have medicare do you have a supplement?
Medicare does not require pre approval you just have the surgery if
medically necessary. Go to the medicare web site and look it up what the
requirements are.
— nefish
December 11, 2005
It only took me 3 business days tobe approve by medicaid. And I did not
need a six month history of a diet or PCP.
— believe47
December 11, 2005
Your question was why the wait. Well, most people who want surgery are
willing to wait if their insurance will pay. I think that the process I
went through really helped me with the process. I really had to decide if
this was for me. It is a very serious surgery and life altering. I know
of people who have put on weight and want an easy way of doing things. I
also know that this was not an easy process to put myself through. I
finally had to admit that I could no longer do this myself. I needed
professional help not just a pill to lose the weight. If I had not have
had all the testing to make sure that I had no underlying health issues I
would have been very worried. I am glad that I knew everything and could
ask questions about each process and procedure. If you rush the process
and don't know the possibilities how can you prepare yourself for recovery?
This is only a tool everything else is something you have to do on a day
to day basis. If you can't whole heartedly committ too then maybe this
isn't for you. Like I said before this is a life changing event that won't
change just because you had surgery.
— 1968 Loser
December 12, 2005
First off, most of the reputable Doctors doing this surgery require your
"informed consent". They want their surgery to be
"successful" and that requires a number of committments from you
and without being fully informed and committed to doing what it takes to be
successful, the odds are you won't be.
It took a lot longer than six months to become obese, surely you can
commit to learning and doing everything requested of you in the six months
and be a better informed patient AND more importantly, a successful one!
I know it seems like an eternity. I started the process with Kaiser
on March 31st, was approved September 30th and had my RYGB on December 1st.
I am SO GLAD I did everything required of me and my research. Nothing was
a surprise and my anxiety level was lessened due to knowing what was
happening and why. It was well worth the wait.
Laura
— LauraA
December 12, 2005
They want you to prove that you tried to lose weight without the surgery
and were unable to do so.
— Novashannon
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