Read More About John:
| Age | 45 |
| Lifecycle Path | Surgical Weight Loss |
| BMI * | Over 40 |
| Weight Loss Wish | 150 lbs or more |
| Wish After Weight Loss | to hit the slopes with his son this winter. |
| * BMI scoring categories are based on guidelines established by the National Institute of Health. [ Understand more » ] |
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Skinny Wishes Profile Results
| Related Chronic Conditions | Sleep Apnea |
| Previous Weight Loss Attempts | Commercial Weight Loss Program (like Weight Watchers) |
| Total Amount of Time Trying to Lose Weight | 5 years |
| Physical Activity | None to Mild (grocery shopping) Can’t afford local gym membership |
| Current Participation in Support Groups | None |
| Participation in Medically Supervised Programs | Primary care provider |
| Insurance? | Yes |
Next Steps
Research shows that morbidly obese individuals are ideal candidates for bariatric (weight loss) surgery. Because John is covered by insurance, he has the potential to be approved for the operation. It is important to note, however, that there are certain requirements from insurance companies before the surgery is approved, and John has not fulfilled several of them. It is recommended that he speak to a medical professional in order to seek out ways to smooth along the insurance approval process and to discuss how best to prepare for surgery. The documented checklist may include:
- Medical care: John should be documenting his weight loss for the insurance company. Depending on his insurance, the requirement for documentation can be as short as three months and as long as one year. This is particularly important because he has sleep apnea, which is a chronic condition related to obesity. Suggestion: start with your primary care physician to see if he/she is the right caregiver in this case.
- Exercise program: Although physical activity is low on John’s priority list, it is important that he demonstrate to his insurance company that he is trying to get healthy. Not everyone can afford a monthly gym membership, so ask your medical provider what some alternatives might be and don’t forget to document those activities accordingly. Make sure you call your insurance company as well. Some may cover a portion of gym membership fees.
- Alternative weight loss programs: In addition to commercial weight loss programs, there are many other programs, centers and facilities that are supervised and/or approved by board certified weight loss doctors or nutritionists that focus on weight loss. They might range from support groups, light exercise programs, behavior modification therapy and more.
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Learning at Skinny Wishes
List of Insurance coverage for bariatric surgery, Aetna, Blue Cross Blue Shield, Champ, Cigna, First Health, Great West, Health Scope Benefits, Humana, Principal Financial Group, Unicare, United Health Care.
Bariatric surgery procedures used for treating severe obesity has been studied as a cure for type 2 diabetes mellitus
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Questions covered are: What types of bariatric surgery do you perform? Factors used to decide which procedure to perform? Surgery disqualifications? Do you provide ongoing support?
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Do I meet the criteria for having bariatric surgery? What risks are involved in bariatric surgery? How long will my hospital stay be?
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