Nictrex92

6 MONTH SUPERVISED WEIGHT LOSS WEIGHT GAIN???ADVICE PLEASE

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Okay so i need advice and idk where else to go......im suppose to have surgery in march of 2018 THIS YEAR yay lol well i have 2 weigh ins left but my problem lately is ive gained back the 15 pounds that ive lost the past 4 months....i have not gone over my first weigh in weight but im so worried my surgery will be cancelled...dont worry i do plan on getting this off with an even more restricted calorie diet..but i have Anthem BCBS and was wondering has anyone gone through this and still get accepted?????

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Welcome to TT! I had Anthem BCBS when I had WLS and I know my weight was up after I did my 6 months of weighing in. My six months of supervised dieting happened before I actually met with my bariatric surgeon and before the weigh in (and much higher weight) that qualified me for surgery. So in my experience, the weight gain didn’t make a difference as far as insurance approval, but I know my surgeon wouldn’t have cleared me for surgery had I not hit the weight loss goal she had for me pre-op. But different surgeons have different requirements, so that might not be an issue for you.

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1 hour ago, Nictrex92 said:

Okay so i need advice and idk where else to go......im suppose to have surgery in march of 2018 THIS YEAR yay lol well i have 2 weigh ins left but my problem lately is ive gained back the 15 pounds that ive lost the past 4 months....i have not gone over my first weigh in weight but im so worried my surgery will be cancelled...dont worry i do plan on getting this off with an even more restricted calorie diet..but i have Anthem BCBS and was wondering has anyone gone through this and still get accepted?????

You will be having surgery at the same time that I do! I also had to do the 6 month weight loss thing. It was to show at attempt at losing weight. I do not have a weight loss requirement from my insurance company. If I did I would be in deep trouble.

I have 2 more classes and weigh ins and surgery will be scheduled.

One more thing. My surgical group did not use my weight from when I started the program. I just met with surgeon a few weeks ago. That is the weight that will be submitted to my insurance company as starting weight.

Edited by Readytobeme

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I am required to do a liquid optifast diet for 1 month prior to surgery by my surgeon. I have to lose 8% of my excess body weight before she will do my surgery.

I did find this info for Anthem.

Anthem BCBS Pre-Approval Requirements

The items below are the minimum necessary for approval of your weight loss surgery.

  • Body Mass Index (BMI) of 40 or greater OR…
  • a BMI of 35 or greater with at least 2 comorbidities.
  • Primary Care Physician’s Letter.
  • Active Participation and Documentation of non-surgical methods of weight loss.
  • 18 years of age (special consideration if under 18 with severe morbid obesity and special circumstances).
  • Consult and recommendation from a weight loss surgeon.
  • Psychological evaluation
  • Nutritional evaluation

 

Here is their statement direct from their site

https://www.anthem.com/medicalpolicies/policies/mp_pw_a053317.htm

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