Insurance question

[TNT1982]

What exactly does it mean when the only requirement for my insurance to approve me is that I had to have had 12 consecutive months of obesity management? Every time I go to the doctor we talk about my weight and the issues I have with it.

[Donald G]

Pretty sure it means that your enrolled in a program where you are seeing a dietician and/or attending meetings.

[DesertGal]

Yes, it sounds like your insurance is requiring 12 months of being in a managed weight loss/nutrition class. That is long, I've heard of six months and my insurance required 3.

[Shirl]

It means you may have to see a dietician and an internist once a month so they can monitor your weight. Mine was 90 consecutive days or three months, but the whole process took me six months because the people in the clinic didn't set me up for my "first medical supervised weightloss appointment" until end January 2016, and my first visit with my surgeon was in November 2015. Psych eval and endoscopy was done in November too a week after my initial appointment. I ended having surgery on May 17, 2016 and it was perfect timing so all turned out well timing and overall. I really had time to learn a lot about the surgery pros and cons.

[OwnYourJourney]

i had 6 month of that and i just needed my dr to weight me everyone same date and talk about the diet path i was on and i couldnt gain weight obvi goal to lose but i basically maintained weight the whole 6 months and surgon gave me the forms for the dr and they submitted it to insurence company with all the other requirements ....best of luck

[Bagawk!]

My insurance did not specifically require classes. I just had to see my primary for several consecutive months for weight loss. The doctor then filled out a log with data for each month and the insurer approved the surgery. The insurance requirements can vary payer to payer and policy to policy so best bet would be to get details of your plan requirements directly from your insurer/payer.

[Christie13]

I had 6 months of supervised weight management with a doctor/nutritionist. The visits had to be specifically 31-35 days apart. Had to have my weight tracked. Could not gain weight at all. There were also some other requirements but that was my rules for the 6 months obesity management. Talk to your surgeon. Most of them know all the different insurance requirements inside and out. I know as soon as mine knew I had Aetna they laid out the requirements for me and we followed them to the letter. Good luck!

[Gvn71]

Call your insurance company. As you can see from all the responses they are all different and have different requirements. Mine only required that I had been obese for at least 2 years prior to surgery and that I was treated by a doctor for it. No crazy 12 month diet program, etc. call your insurance, they'll tell you exactly what you need to do.

[jamma]

My requirement was also one year of supervised weight loss, but luckily, I could document that I had been in various plans that covered more than a year. I had my weigh-in sheet from one of the many programs I had joined before starting the WLS journey.

[TNT1982]

Thank you everyone for the responses. I had oral surgery today so once I can talk again I will be calling my insurance company on the specifics