Howdy!

[mysticalmalissa]

Hey everyone, I'm brand spanking new to the site and hoping to learn a lot from everyone here. I have my very first appointment on Wednesday and am sort of scared of what my insurance is going to make me do to get approved. My insurance is from the state because I am disabled and I am worried about the hoops they will make me jump through. I've already seen something about a 3 month diet on my health chart app and all I can think is, if I were good at dieting, I wouldn't need to get my stomach hacked up. Has anyone ever had to diet for months and been turned down because they didnt lose enough?
Thanks in advance!
~mysticalmalissa

 

[Kcuster83]

Hello and welcome!
I had a 6 month process through insurance. Appointments, classes, etc. It was not demanded that I loose any weight. Our only "weight related rule" was that once you did your final weight check you could not gain any weight from that day till the day of your surgery.

 

[KarenWV]

Hey everyone, I'm brand spanking new to the site and hoping to learn a lot from everyone here. I have my very first appointment on Wednesday and am sort of scared of what my insurance is going to make me do to get approved. My insurance is from the state because I am disabled and I am worried about the hoops they will make me jump through. I've already seen something about a 3 month diet on my health chart app and all I can think is, if I were good at dieting, I wouldn't need to get my stomach hacked up. Has anyone ever had to diet for months and been turned down because they didnt lose enough?
Thanks in advance!
~mysticalmalissa

Hi and welcome to our group. I have state run insurance also. I started the ball rolling in September 2020, and did not have my gastric bypass surgery until July 2021.

The process required by my bariatric team and insurance included 6 months of a documented weight & exercise program through my pcp's office. Because my weight and bmi were at the lower end of the numbers required by insurance, my monthly visits mostly were to ensure I was eating healthier, not gaining weight, and doing some movement/exercise.

Each program will have its own guidelines, instructions, and requirements. Trust me, if these were too difficult to follow, they wouldn't be able to stay in "business" for long. You probably will be required to attend eductional class/classes, have bloodwork and tests to make sure you are healthy enough for surgery, go to a psychologist to ensure you are stable enough to follow the requirements, and a few other things to do.

It is a lengthy process, but you should appreciate that they care enough about their patients to make them ready for such a huge lifestyle change. Good luck and please keep in touch with us. You CAN do this, and you already have taken the most important step, admitting you need help to become a healthier, happier you! ❤❤

 

[dianeseattle]

Hi and welcome to our group. I have state run insurance also. I started the ball rolling in September 2020, and did not have my gastric bypass surgery until July 2021.

It is a lengthy process, but you should appreciate that they care enough about their patients to make them ready for such a huge lifestyle change. Good luck and please keep in touch with us. You CAN do this, and you already have taken the most important step, admitting you need help to become a healthier, happier you! ❤❤

Have you checked to see if you qualify for a Medicare disability plan? I did. The hospital knows all this kind of stuff and there was a person there whose job it was to make sure you knew that and qualified. My hospital also had a subsidy plan based on my tiny income, and paid into the plan as well. It didn't cost me anything and I got super good health care as a result. I know the process is much different now, but you should really pursue all avenues, including getting doctors to write letters for you recommending the surgery. But the fact is, being overweight is a dangerous disability and it's incumbent on medical professionals to make sure you get the help you need to save your life. You are entitled to this care but sometimes you have to fight for it. But i think there's always a doctor who can test you and even write letters on your behalf. Don't give up. That's what so many medical organizations are hoping for. Stand up for yourself and fight for your rights.

 

[missyinacage]

Almost all insurance has requirements that you must meet to be approved. It's not so much about how much you lose, its about showing that you can learn and follow guidelines.

Right up until surgery, I thought that since my stomach was being hacked up, as you put it, I would of course lose weight. Which you do. However, you also do not eat solid food for anywhere from 3 to 10 weeks. WLS gives you ah chance to change your habits without your hunger hormones screaming that your starving 24/7.

It is work,both before and after surgery. But it is100% worth it!! So, do whatever they require and don't get discouraged. You can do it and you will be very happy you did.

 

[Roni]

Before surgery I read a lot of post op posts about feeling hungry aka starving. The program I was given for eating before surgery was about getting protein, fats, carbs and dairy in certain quantities. I did lose weight with it. But it was more about making better food choices. Weight loss journey is a process. It is not easy. It is about being committed to making better choices.