Question:
How do I get a yes the first time?

Okay Call me crazy....I am on my month 3 with my reg Dr. ....my fear is that my insurance will still tell me NO even after the 6 months.... I need to know what I need to gather to get a YES I hope on the first time...or anyother info you may have..    — playgirl2077 (posted on September 2, 2008)

September 2, 2008
If they put you on a six month supervised diet, as a pre-certification step. It sounds like the steps toward "Yes". Alot of insurance companies require this, I believe to give people plenty of time to think about this. It is not something to be taken lightly, and alot of study and research should take place for the pre-op person. I've never heard of anyone going thru the 6 month diet, and getting a "No". That would be a dirty trick wouldn't it? Use this time to learn all you can, and don't worry. You'll get here! :)
   — lesleigh07

September 2, 2008
Contact your insurance company to ensure that you know everything that needs to be included for their approval. The majority want 6-months on a structured diet, want you to meet with a psychologist and a nutritionist, require you to complete certain tests and blood work, etc. Good luck!!
   — Mandee B.

September 2, 2008
Hi, My advise would be to talk to the office manager to see if they have dealt with your insurance company in the past. If so then ask him/her to review your chart to be sure that they have received or are scheduled to receive all the information from you or any professional you have seen or will see. They certainly would know what the insurance company expects. I would also recommend calling the insurance company and get all the information sent to you on covering weightloss programs and surgery. My insurance company sent me a packet of information. You should have received a list of necessary appointments from your Bariatric Clinic. Follow directions exactly and make the best effort to lose something every month. You should be fine. I had very few co-morbidities, slight sleep apnea, high cholesterol and I am almost three months post op. Good Luck!
   — yankeefan75

September 2, 2008
do everything they tell you to do -- don't shortcut anything -- and not everyone gets denied -- i was approved the first time with Aetna after everyone says how tough they are -- i did my 6 month dr supervised diet, my surgeons pre-op tests, and whatever else the dr told me to do -- and i never once called the insurance company -- the surgeons office handled everything from soup to nuts :)
   — RCassety

September 2, 2008
If you are a good candidate for WLS you will get approved. If you are not approved, there is usually a good reason. WLS is a HUGE life changing surgery. If it's not worth the risks of dying for, you shouldn't have it! WLS is not only for weight loss...It's for health. If you have no health issues, and I was a health insurance company, I would tell you to go on a diet, because that's what you have to do after WLS anyway. You HAVE TO CHANGE your diet. So many people do not understand that. I don't understand why someone would want to alter a large body if there are no health issues...it just boggles my mind...and I totally understand wanting to be thinner...But I would have glady lived my life in a healthy 200-215 lb body, than have surgery. That's just my flat out honest opinion...I do not know your history or anything...I'm not judging either...I am talking in general anyway! So if you are a candidate, you just are...and if you are not...there is not much you can do about that...I heard of people so desperate to be thin that they try to gain weight to meet the weight requirement...and I just don't think that's the most distructive and ungrateful way to make insurance companies begin stricter guidelines for those of us who TRULY need the health benefits of WLS and not just to be petite...I wish you much luck and success in whatever happens...And sometimes what you WANT is not always what you need...and sometimes NOT getting what you want is exactly what you need...(Still, I wish you all the luck in what you want! )
   — .Anita R.

September 4, 2008
I was worried about that as well.....however, I had diabetes, high blood pressure, and very high cholesteral issues..........so I was approved immediately. I went and met my surgeon on March 21 and had my surgery on July 1st. Good luck! Magdalena
   — Magdalena52286