Questions about Insurance Requirements

[TransitionalJourneys]

Hello!

I am new here. :-) I have been considering wls for a long time, but finally decided to take the step. I have my consultation on November 8th. I am reviewing the requirements for surgery set up by my insurance (when I called in they said to simply wait until they get the pre-authorization to determine what I need to do), but online it has a long list of the basics I've read on here... chest x-ray, sleep apnea test, recent blood work for deficiencies, mental health evaluation, etc. I am preparing for the "if I have to do everything".

I already see a psychiatrist and have been since April and before then, I was meeting with a therapist. I also have to be weighed at every psych appointment and had a drug test as a requirement to getting psych treatment. The requirements also state 6 months of counseling prior to surgery. My psych is aware and supportive and my PCP is also aware and supportive of my weightloss. I also had a chest x-ray less than a month ago and additionally had blood work addressing some of their mineral concerns such as TSH for hypothyroidism completed within the last 6 months.

I know every insurance and doctor is different so I know that I'll get different answers, but did anyone have several things already done via PCP or other healthcare provider that counted towards their insurance requirements?

Thank you so much!

[Christie13]

Yes I had a long list of things to do. I wonder if your psych visits will count as 6 months of supervised weight loss since they weigh you every time?? My insurance required the 6 months. I could not gain weight during that 6 months. I also could not drop below a 40 BMI as none of my comorbidities counted. My appointments also had to be between 31-35 days apart to count. But I did have other requirements like EKG, pysch evaluation, blood testing, nutrition visits etc. I did not have to do a sleep study but see that on here a lot. Good luck. Just make sure you write the requirements down so you can make sure it is all done right.