Supervised diets are frequently required by insurance companies prior to authorization for weight loss surgeries such as gastric sleeve or gastric bypass.  There is no data published that shows supervised diets improve any outcomes whatsoever. However it is still very common for patients to have to go through a 3-month or 6-month program and demonstrate an overall weight loss from start to finish.  Here are some tips to ensure a smooth approval process for your weight loss procedure!

• How many visits are required?
  • The vast majority of plans require either 3 months or 6 months.  Some require none at all.  Rarely, plans will require more than 6 months. Work with your insurance team or call your carrier to find out exactly how many is required for your specific plan.
• Will they count your initial consult?
  • Some carriers will allow you to count your initial consultation as your first supervised diet visit. Others exclude it and don’t start counting until the next visit. Find out what your policy requires so you can plan properly.
• Are any specific weight loss goals are required?
  • Some plans just require that you complete the specific number of supervised diet visits.  Others require an overall weight loss from start to finish. It is uncommon, but not unheard of, for there to be a specific weight loss requirement. You need to know for sure so that if a goal is required, you can make sure you it.
• With whom can you do your supervised diet?
  • Sometimes you have to do your supervised diet with your surgeons office.  Other times it’s required to do it with someone other than your surgeon. Don’t waste your time by doing your supervised diet with the wrong doctor!  If you are going to do your supervised diet with your PCP, here is a helpful form to take to each visit to make sure documentation is complete.
• What is your BMI minimum?
  • All policies will have a certain BMI which you must be above in order to qualify for surgery.  Most of the time this is:
    • A BMI of 35-40 with at least two weight-related issues (diabetes, sleep apnea, etc) OR
    • A BMI above 40, regardless of weight-related issues
  • Find out what your policy requires and whether you have qualifying weight-related issues, and find out what your weight would be at that minimum BMI to make sure you don’t drop below that.  If you do, it would most likely disqualify you from approval.  You can use a reverse BMI calculator to help you figure this out.
• Are there any other requirements?
  • Does your policy require a letter of support from your PCP, thyroid labs, or drug testing?  Most don’t, but some do so you need to know! As an example of what can be required, here is the Obesity Surgery Precertification Request Form for Aetna.
• Make sure you have a visit each month, but not more than once per month.
  • Unless you are on a weekly supervised diet plan, make sure you come in for a supervised diet visit around every 4 weeks, but not twice in one month.  For example, let’s say you came in for supervised diet visits on January 1st, January 31st, and March 1st. Your carrier would most likely say you skipped February, even though you were coming in around every 4 weeks.  A visit January 1st, February 1st, and March 1st would solve this problem, even though there is only a 1-day difference in the middle visit!
• Make sure your last one is really your last one!
  • After your complete what you think is your final supervised diet visit, make 100% sure that it really is the last one needed.  If there is any uncertainty whatsoever, do another one the following month.  If for any reason it is determined that you needed one more, and more than a month has passed since your last one, you have to start over at the beginning!

Navigating a supervised diet requirement is not difficult once you get all the facts, so make sure you have gathered all the proper requirements for your plan. If you have any questions or unsure about any of your requirements, please email our insurance team at insurance@curryweightloss.com.