Waiting for year

bobo_mom
on 11/13/13 2:26 am

I am new to this board and am just in the beginning phase of the VSG.  My insurance makes me go to my doctor for weight management monthly for 12 consecutive months, and talk to a health coach after each appt.  If you miss an appt, you start all over again.  In the first 3 months, I have lost 15 lbs, down to 230, at 5ft 3in.  I anticipate that this will stall (as always) around 210, and then go back up.  What I am afraid of is that insurance will say that I am proving I can loose and won't approve the surgery.  Wi**** was that easy to loose and keep it off, but if it was, I wouldn't still be 230 lbs!  Did any of you have to wait a year, and still kept up hope of getting the surgery?

LosingSarah
on 11/13/13 3:16 am - Moorhead, MN
VSG on 10/16/13

You are the first person I've heard of who had to follow strict rules like that. I had to have 6 months and it didn't have to be consecutive, but within the last couple years or something like that.

Does your insurance require weight loss before they'll approve you for surgery. If not, then you shouldn't have to worry about anything. I would call your insurance company and find out what there requirements are.

I know I didn't have to lose anything. My doctor didn't either (some drs do). He said, if you could lose weight on your own you wouldn't need surgery.

Good luck!

    
Nikke2003
on 11/13/13 3:19 am - PA
VSG on 05/13/13

That's a bummer that you have to do the diet for the entire year. I was required to do six months and although my insurance didn't require weight loss, the weight management clinic required that I lose 44 lbs (10% of my body weight) in order to have surgery. If your written policy doesn't say anything about being denied because you lost weight, then I would hope they wouldn't (or couldn't) deny on that reason. I lost 107 lbs during the supervised diet and I was not denied. BUT, I guess you can never put anything past an insurance company!

For more info on my journey & goals, visit my blog at http://flirtybythirty.wordpress.com

  

The_True_KayD
on 11/13/13 4:50 am

My insurance requires 6 mos of being in the program including "classes". That meant meeting with the nutritionist, behaviorist. My program has a month of classes that met once a week. I did check with my insurance about preferred hospitals.  I went to that program. I didnt mind the 6 mos because I was able to make and solidify behavior changes and worked on the head stuff.  I did loose weight and did have a slight increase at once point. I was just approved and having my sleeve done on Dec 3rd. 

Those rules seem to be too extreme! Is there another program that you could go to? 

  HW: 249  SW: 233  VSG: Dec 3, 2013    

             

        

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