Question:
Trying to get insurance to approve me for surgery, 4 months after having baby.

Has anyone else gone through this? My insurance will pay for the surgery if referred and felt necessary. But, you also have to prove that you have had 6 months of diet w/physician care within the last 12 months. I was pregnant, and lost weight while I was pregnant, but gained it back. So when I had my baby I weighed 1 lb less than when I started. I did however, within this four months, manage to gain some more weight. Do you think this will qualify? I was dieting (eating more halthy) and under a physician's care. The insurance doesn't stipulate that you cannot be pregnant during that time.    — [Anonymous] (posted on July 13, 2001)

July 13, 2001
I too am going through this my daughter was born March 1st. I have been going back and forth with Kaiser. So far I just need my PCP to send in a letter saying I am fit enough to have surgery. After they get that I will be able to get in with the other DR.'s to START with all the test. I hate waiting but I have a feeling they are just going to keep putting it off as long as they can. Good luck let me know what happens.
   — Amy M.

July 13, 2001
Hi. I had the BPD/DS surgery on 4*6*01, when my daughter was 5 months old. The insurance company never even questions it. I started to see doctors when she was only 3 months and thank goodness no problems. I don't see why having a child should effect anything. I gained 20 pounds with my daughter and lost the 20 pounds by my 5th post-op day(i had a c-section) when I went to get the staples removed. When I went back for my 6 week check-up, I had gained 6 pounds in 6 weeks! I freaked out and called the surgeon's office right away. They never had anything to say about the fact that I just had a c-section. They just wanted to wait until it was about 6 months after the c-section. That was it. If you were already heavy before the baby then I do not see why they will not approve you. Maybe you can copies of the OB's records as back-up. If they see the weight that you started out in the beginning of your pregnancy maybe it would help. This way it doesn't look like you are trying to get rid of the "baby weight" Good Luck
   — Johna F.

July 13, 2001
I also lost weight during my pregnancies. My PCP included this in his recommendation for the surgery stating that while under the care of my OB/GYN, I was able to effectively lose weight, but as soon as I was no longer under her direct care I would gain back all the weight and then some - meaning that after I had each baby, I put on all the weight I'd lost becasue I was sick as a dog and couldn't keep anything down while I was pregnant. My PCP also included all the times that I did Weight Watchers in between the pregnancies and that I took Meridia under his care right after my last baby. I had my surgery when my youngest was 6 months old and the insurance never even questioned anything.
   — Terry M.

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