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Coachy71

6 Month rule ?

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I have been reading the forums and see a lot about the 3 or 6 month rule. I started in August and meet with my surgeon tomorrow, and there has never been talk about this rule. Is this something the surgeon will drop on me tomorrow, or because I haven't heard anything about this from the hospital, I am in the clear?

Thanks for your help and thoughtful responses.

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5 minutes ago, Coachy71 said:

I have been reading the forums and see a lot about the 3 or 6 month rule. I started in August and meet with my surgeon tomorrow, and there has never been talk about this rule. Is this something the surgeon will drop on me tomorrow, or because I haven't heard anything about this from the hospital, I am in the clear?

Thanks for your help and thoughtful responses.

What is this rule? I've never heard of it.

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A lot of times the 3 or 6 month rule is an insurance requirement. Mine didn't have one (BCBS of Illinois), but there is a very wide range of experiences when it comes to insurance. And programs, for that matter. Have you checked with your insurance company? 

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Sorry, I should have been more precise. That you have to be on a supervised diet for 3 or 6 months.

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1 minute ago, Michael_A said:

What is this rule? I've never heard of it.

I assumed he meant the months of supervised weight loss. Perhaps I'm wrong, though? OP, can you clarify? 

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3 minutes ago, Coachy71 said:

Sorry, I should have been more precise. That you have to be on a supervised diet for 3 or 6 months.

That is controlled by two things- your insurance, and your surgeon. MOST, but not all, insurance requires a 6-month pre-op program of some kind, the "standard" version of which includes that you must have a BMI over 40, OR a combination of several co-morbidities like sleep apnea, type 2 diabetes, etc.; 6 monthly visits with a medical person in which you are weighed and "some kind" of documented attempt at weight loss; a psychological evaluation to make sure you are mentally prepared for the lifelong requirements of WLS; a visit with a nutritionist. But some programs only require 3 months and some variation of the above, and others require nothing.

Besides the insurance, your surgeon may have a specif program you have to follow. Even if my insurance company would have immediately signed off on my surgery, my surgeon would have made me go through a 6-month program anyways.

Your insurance company is the first place to start. A quick phone call will answer your question.

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I guess I will know for sure tomorrow at my appointment. I'll log in and tell everyone my news. Fingers crossed that it will be a surgery date!

Thank you all again.

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I have read practically more than my head can hold over the last year preparing for this surgery. I have heard of the 3 or 6 month supervised diet rule that is mandated by insurance companies ( I have one myself) but, I have yet to hear of anyone having one from their surgeon. Doesn't mean it doesn't exist but it has to be very rare.

I do have some requirements that I have to meet mandated by my surgeon. I must attend at least 10 support groups, be evaluated by psychologist, pass nutritional eval and a few other things.

My guess is that if you have not heard about it yet, your insurance does not require it. Will be curious to hear what they say tomorrow. I learn new things every day.

Good luck!

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My surgeon required it, but that was because my hospital is considered a "bariatric center of excellence" and there are specific standards they are expected to meet. It's also a way for them to make more money :D Granted, my insurance required it as well. I had to do weekly classes for 6 months, the standard is monthly weigh ins for six months, so I'm far from the norm. 

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5 hours ago, delilas said:

My surgeon required it, but that was because my hospital is considered a "bariatric center of excellence" and there are specific standards they are expected to meet. It's also a way for them to make more money :D Granted, my insurance required it as well. I had to do weekly classes for 6 months, the standard is monthly weigh ins for six months, so I'm far from the norm. 

My hospital is also a bariatric center of excellence. The surgeon has plenty of criteria that I have to meet before surgery. Waiting 6 months is not one of them though. I am doing my monthly weigh ins with them but, that is to satisfy my insurance.

These are my surgeons requirements.

  • You must complete Five (5) Pre-Op prep classes before your initial surgeon’s appointment
  • You must complete Ten (10) Pre-Op prep classes before your surgery date
  • If pre-op prep classes held on the same day have different topics, they may each count towards your 10 classes. Pre-op prep classes with the same topic held in one day may only count once toward your 10 classes
  • NO Pre-op prep patients in Post-surgery classes
  • After surgery, you will advance to the post-surgery support groups
  • Questions for the office staff or physician must be handled during office hours (8am-5pm Mon-Thurs, 8am-12pm Fri)
  • All patients must sign and weigh in for Two (2) Pre-op prep classes a month.
  • If you are weighing in, please arrive 15-30 minutes before class is scheduled to begin to get vitals recorded, NO weights/vitals will be taken once a Support Groups class has started or at any other times throughout the day.

*As part of the 10 required pre-op prep classes, (5) classes/topics are mandatory including: Surgery 101, (1) Physician group, (1) Dietitian group, (1) Nurse group, and (1) Psychology group.

Pre-op prep classes are restricted to 50 attendees, patients arriving after the capacity limit has been reached will not be allowed to join the group regardless of the time.

 

Other than those requirements, we just have to go through psychological testing and pass the nutritional evaluation.

Edited by Readytobeme

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