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  1. #1
    Gastric Sleeve Member
    I have not had a gastric sleeve.
    Surgery date
    03/13/2017
    Surgeon
    Dr. Jiser
    Join Date
    Aug 2016
    Last Activity
    03-10-2017 09:50 AM
    Location
    Massachusetts
    Posts
    6
    Said "Thanks" 0 Times
    Was Thanked 2 Times in 2 Posts
    Said "Welcome to Gastric Sleeve" 11 Times

    Default Insurance wording

    My insurance policy states -2.The individual must have serially documented active participation in a non-surgical weight reduction regimen for at least 6 continuous months, in the 2 years prior to surgery, to enable both behavioral changes and adequate assessment of anticipated postoperative dietary maintenance. These efforts must be fully appraised and documented by the physician requesting authorization for surgery. I have seen other insurance state 6 months of medically supervised diet...Would you consider this the same??? I am going to call to clarify, but just thought I would ask. I read it as as long as I have at least 6 months trying such as weight watchers, etc, then I am good to go. Just hoping I don't have to wait 6 months from when I started this process, but it may be that too



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  3. Gastric Sleeve Surgery With Weight Loss Agents
  4. #2
    Gastric Sleeve Member Sarcastic_Bard's Avatar
    I have had a gastric sleeve.
    Surgery date
    12/29/2015
    Surgeon
    Dr. Vierra
    Join Date
    Feb 2016
    Last Activity
    01-23-2018 01:50 PM
    Location
    Maine
    Posts
    292
    Said "Thanks" 111 Times
    Was Thanked 272 Times in 168 Posts
    Said "Welcome to Gastric Sleeve" 448 Times

    Default Re: Insurance wording

    Do you have documentation from a WW clinic showing you regularly went to meetings, worked with a WW coach, etc.? If you don't have documentation showing you were fully involved with the program and everything you did with WW during a six month consecutive period I don't think your insurance will accept it. If you have that documentation, it sounds like your surgeon would have to have the documentation and confirm for the insurance that it meets the non-surgical regimented weight loss requirements before they would approve your surgery.

    If that is the case and you don't have the necessary documentation, you will have to work with your surgeon/dietitian while you prepare for surgery for six months. If this is the route you have to take, do NOT miss any appointments. Most insurances that require this supervision will make you start all over if you miss any appointments during the six months. Rescheduling is fine, but don't skip any appointments.



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  6. #3
    Gastric Sleeve Member KariVSG's Avatar
    I have had a gastric sleeve.
    Name
    Kari
    Surgery date
    11/08/2016
    Surgeon
    Dr. Kaplan
    Join Date
    May 2016
    Last Activity
    05-09-2021 02:38 AM
    Location
    West Virginia
    Posts
    554
    Said "Thanks" 352 Times
    Was Thanked 200 Times in 182 Posts
    Said "Welcome to Gastric Sleeve" 495 Times
    Blog Entries
    33

    Default Re: Insurance wording

    my insurance will get my paperwork on the 19th of this month so i will have a surgery date next month



  7. #4
    Gastric Sleeve Member Pam G's Avatar
    I have had a gastric sleeve.
    Name
    Pam
    Surgery date
    05/27/2016
    Surgeon
    Dr Ponce de Leon
    Join Date
    Feb 2016
    Last Activity
    02-22-2024 08:48 AM
    Location
    Sugar Land, TX
    Posts
    1,543
    Said "Thanks" 679 Times
    Was Thanked 771 Times in 544 Posts
    Said "Welcome to Gastric Sleeve" 57 Times
    Blog Entries
    12

    Default Re: Insurance wording

    Have you ever done WW? Do you still have your little weigh in booklet?




    HW: 275
    PreOp: 268 5/12/16

    SW: 258. 5/27/2016
    10 w: 225. Goal 1
    12 w: 222.
    14 w: 216.
    4 m: 215
    5 m: 205
    22: 199.4 10/30 Goal 2
    24: 196
    6 mo: 191
    7 m: 193
    8 m: 184
    9 m: 180 2/3/17. Goal 3
    10 m: 179
    11 m: 171
    48: 170
    1 yr: 166.6. 5/27/17
    13 m: 165.8
    5 y,10 m: 215
    7 yrs: 230


    Revised Goal : 200
    "Bonus" Goal: 180

  8. #5
    Gastric Sleeve Member Soundr's Avatar
    Join Date
    Dec 2020
    Last Activity
    08-08-2023 04:45 AM
    Location
    Boston
    Posts
    34
    Said "Thanks" 0 Times
    Was Thanked 1 Time in 1 Post
    Said "Welcome to Gastric Sleeve" 0 Times

    Default Re: Insurance wording

    Insurance is very important, and I recommend you to ensure yourself because there are a lot of situations when something does not follow the plan. Even at work, there are a lot of situations when you can get injured. For these situations, you can make yourself insurance, as I did on https://generalliabilityinsure.com/s...insurance.html. Their insurance isn’t too pricey, and the guys are doing a really good job. Take your chances and contact them, they will find a way to help you somehow.

  9. Gastric Sleeve Surgery With Weight Loss Agents

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