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  1. #1
    Gastric Sleeve Member
    I have had a gastric sleeve.
    Surgery date
    12/17/2013
    Surgeon
    Dr Gluck
    Join Date
    Aug 2013
    Last Activity
    12-16-2014 08:39 PM
    Location
    Michigan
    Posts
    19
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    Was Thanked 6 Times in 4 Posts
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    Blog Entries
    1

    Default Did you have to write an appeal letter? Did insurance still accept even if you didnt do the whole 6 mo req. supervised diet?

    My insurance requires a 6 mo supervised diet. I did 4 but couldnt afford it after that and stopped (that was a year ago before I was even considering bariateic surgery). Well, they will accept the 6 mo if it was in the last 3 years. Well, my surgeon wrote a letter to the insurance and now we are waiting to hear back if approved or not. They have 30 days total to respond ( already has been about 10). I have a tentative surgery date of Dec 17 and now totally worried that it wont happen! Has anyone not been approved and had to do an appeal letter and then did get approved. Would something like this warrent an appeal letter if it is denied? Completely frustrated as all get out!!



  2. Gastric Sleeve Surgery With Weight Loss Agents
  3. #2
    Gastric Sleeve Member ltlsqueak's Avatar
    I have had a gastric sleeve.
    Name
    Sherri
    Surgery date
    11/20/2013
    Surgeon
    Dr. Kellum / VCU
    Join Date
    Jul 2013
    Last Activity
    08-10-2017 05:59 PM
    Location
    Virginia
    Posts
    774
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    Was Thanked 190 Times in 182 Posts
    Said "Welcome to Gastric Sleeve" 4,149 Times
    Blog Entries
    57

    Default Re: Did you have to write an appeal letter? Did insurance still accept even if you didnt do the whole 6 mo req. supervised d

    Not sure if this is any help, but I didn't have to diet for 6 months because I'd tried so many diets and they also factored in my health issues. Hopefully you will get good news! Best of luck and keep us posted.



  4. #3
    Gastric Sleeve Member
    I have had a gastric sleeve.
    Name
    Lisa
    Surgery date
    11/19/2013
    Surgeon
    Dr. Luciano DiMarco
    Join Date
    Oct 2013
    Last Activity
    04-21-2014 09:10 PM
    Location
    Enola,PA
    Posts
    17
    Said "Thanks" 6 Times
    Was Thanked 5 Times in 5 Posts
    Said "Welcome to Gastric Sleeve" 7 Times

    Default Re: Did you have to write an appeal letter? Did insurance still accept even if you didnt do the whole 6 mo req. supervised d

    Good luck! Mine had to be a 6 month consecutive diet, with some amount of demonstrated weight loss each month.



  5. #4
    Gastric Sleeve Member yankegal's Avatar
    I have had a gastric sleeve.
    Surgery date
    08/08/2011
    Surgeon
    Dr Ramos kelly
    Join Date
    Jul 2011
    Last Activity
    11-06-2013 01:02 PM
    Location
    North Carolina
    Posts
    1,053
    Said "Thanks" 189 Times
    Was Thanked 169 Times in 154 Posts
    Said "Welcome to Gastric Sleeve" 93 Times
    Blog Entries
    7

    Default Re: Did you have to write an appeal letter? Did insurance still accept even if you didnt do the whole 6 mo req. supervised d

    I had tried every diet named to man! but the insurance was so strick, I fought a hard fight, I did two appeals the first was denied even with the letters from doctors. during the last appeal I was to have a phone interview with two others from the ins company, I was so discusted that I decided all the money that I had spent on everything i wasn't going to fight no more so I decided to go to Mx. it was cheaper, less stress, and had it done before my final appeal! I wish you all the luck! they did say after it was all said and done, they wouldn't have covered the sleeve. So I was glad that I did what I did. they did however say that they would possibly cover the band or complete bypass. I have a friend who had the bypass and she hasn't done well at all! she is sick all the time, can't keep any foods down, loss a lot of weight but can't leave her bed. so that is why I made the decission for the sleeve, it was the best decission that I could have made for myself. I recomend don't give up or give in!! my ins went back years to see what if any I was doing about weight loss, well unless you tell your dr to record it, it may not be there for them to view.



  6. #5
    Gastric Sleeve Member Laura H's Avatar
    I have had a gastric sleeve.
    Surgery date
    05/06/2013
    Surgeon
    Dr. Choban
    Join Date
    Jun 2013
    Last Activity
    02-24-2014 09:19 AM
    Location
    Lancaster Ohio
    Posts
    51
    Said "Thanks" 0 Times
    Was Thanked 10 Times in 9 Posts
    Said "Welcome to Gastric Sleeve" 8 Times

    Default Re: Did you have to write an appeal letter? Did insurance still accept even if you didnt do the whole 6 mo req. supervised d

    all insurance companies are different however the requirements they set up they are pretty cut and dry about (I know I work for an insurance company) If they said 6 months consecutive physician weight loss That is generally what they mean You can always appeal it but don't get your hopes up. That is a very common requirement it shows a level of commitment. Sorry I don't have better news to bring you.



  7. Gastric Sleeve Surgery With Weight Loss Agents

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