So, I am almost finished all the hoop jumping that my insurance company/surgeon's office required and we should be able to submit to insurance no later than mid-February. Here is my concern: we had the option of doing one six month structured diet program (sdp) or two three month sdps and we elected to do the latter. We wanted to do all six months with our hospital's bariatric education class, but as they could not get us in until December, we went with three months of Weight Watchers and then three months of the bariatric ed class. SO, we did October, November, December in Weight Watchers and then the hospital got us in for our first appointment in December and we did December, January and soon to be February with that class. So, though we have technically done two three month sdp, it only took us five months to do it as December we did both. When I was setting this up with the surgeon's office, the lady told me that it was fine to do it that way and that it would not be a problem with the insurance company, but now that we are almost finished, I'm fearing it might be a loophole for the insurance company (optimum Choice).

I'm going to call the surgeon's office tomorrow to double check, but do you think my concerns are unwarrented?

Wow Kimbre...I've read this three times and I'm just not clear as to what you're asking. Maybe I've had too long of a day at work. I hope that Celadon can give some advice...I see that she is reading this the same time that I am!

I'll offer hugs through cyberspace...how's that? Right now, it's really all that I'm capable of!

Oh Kim, I'm sorry! It is a bit confusing! If the options were one six month structured diet program OR two three month structured diet programs, is it okay that our two three month programs only took five months as we were doing both in December?

Does that help? Maybe I should have stated it in the nutshell to begin with!

Kimbre...I have nothing but support and hugs to offer....
When I had wls, none of that was required...I wish you only the best and please come back and let us know what you find out....

Sorry I couldn't be more help.
More Hugs!!!!

The "in a nutshell" version is a bit easier. I guess that I would only recommend that you verify with your WLS center that you are doing everything right. THEY want for you to have an easy approval. Honest and true. They don't get paid until you get that approval, so it's kind of in their best interest to make sure that you're doing it all correct.

Ask and be your own advocate!

It's almost impossible to guess what Insurance companies will do, but the bottom line is, you DID the 6 months that they require. You DID YOUR TIME! I think that they'll see it this way too. Do you have any comorbidities like diabetes or sleep apnea? These are real hot button issues right now that help assure that you'll be approved. But no matter, many, many insurance companies are finally starting to see the light: paying for the surgery is going to save them tons of money over letting your health slowly go down the tubes.

I think you've got the thing bagged up!

Good luck.

Yup, yup. I have obstructive sleep apnea and high cholersterol to go along with it. I'll let you know what I find out when I call.

Not sure about the insurance company... but you are wise to ask
any small question. Here's the caveat... Get Answers in Writing!
Someone could make an assumption could be later proven false..
You are a wise cookie!