Health Net?

[em1125 0]

Does anyone have HealthNet? I'm waiting for my approval. Surgeon's office sent it in a few days ago. I don't know how difficult they are. Let me know. Thanks.

Emily

[KittyBoozie 0]

Does anyone have HealthNet? I'm waiting for my approval. Surgeon's office sent it in a few days ago. I don't know how difficult they are. Let me know. Thanks.

Emily

I have healthnet HMO and have the same question.

Kit

[brknbck 0]

I know this is an old post but I was wondering if Health Net paid with out giving you a bad time. I have Health Net and I have seen my pcp and he is sending me to see Dr. Ali I think he is out of the ucd site. I just hope they will cover me I can not pay out of pocket right know.

[em1125 0]

Hi brknbck,

I haven't been on this post for a pretty long time. Your response came to me via e-mail.

The answer to your question is absolutely yes!! They gave me a very hard time. I appealed twice and then I hired Kelly from Obesity Law. In two weeks it was overturned. Health Net will ask that you have atleast 6 months to a year of weight loss supervision with your MD. I had a year of supervised weight loss with a nutritionist and I went up and down in my wieight. They at first said my BMI was lower than the criteria, however, Kelly got that overturned because I also has other health issues, i.e. high cholesterol etc.

It was a four month process for me, but it was all worth it. I love my lapband. I am going on a year in September. I've lost 35 pounds which is not a lot in comparison to what others can do. I don't really diet, I just eat a lot less than I ever did.

Do what you have to do and if Health Net gives you a difficult time, appeal it and if need be hire kelly from obesitylaw.com. She was instrumental in the entire procedure. Any other questions, please let me know if I can be of any help.

Good Luck!!

Emily

[brknbck 0]

Thank you for the info I guess I should get ready for a fight. Where do you live I'm in Camino, CA or as most people know it apple hill it's in El Dorado county. If they do not pay I will have to start saving the more I read on this board the more I know this is what I need.

[em1125 0]

No problem. I'm from Westchester, New York. Believe me, I wanted the lapband so badly, that I was self pay right up until 3 days before the surgery. That's when my appeal was overturned. Thanks to Kelly from obesitylaw.com.

Good luck and best wishes to you. Let me know what happens with Health Net.

[hopefullystillinwaiting 0]

Hello All,

I had signed on here a couple of years ago as Hopefullyinwait now Hopefullystillinwaiting

I have been looking into having surgery for about 6 years now. I was putting my time in as Health Net requires, I had about 8 months time in but became very sick from female problems. I had surgery for that and now that I am ready to get started again with the weight loss my Dr. now tells me I have to go through all their games again! She says it is due to the insurance co. Does anyone have any information on this... I was trying to find out information when it sent me to this site... I am hoping the one who started this page was blessed with your surgery and is now health, slim & trim:thumbup: I would love anyone's help if you know of any Dr. that do not make you play all the games as mine is saying nessesary to do again. I have many health problems and they seem to be adding up as time goes on. It hardly seems fair that I should have to play any longer, 6 years is more than enough. Living in High Desert Apple Valley, Ca area.

Thanks to All...:cool:

Edited November 15, 2008 by hopefullystillinwaiting
adding old e-mail name

[em1125 0]

hopefullystillwaiting,

I don't understand. Your doctor is telling you that you need to go through this again. That doesn't make sense. If you have been struggling with your weight for six years and have a lot of it documented then you shouldn't have a problem. Where are you from? and Explain who is telling you this. Your doctor or surgeon? Is the eight months of documented supervision recent or from six years ago? I'm a little confused as to why they don't try to put it into your insurance to see what happens.

[hopefullystillinwaiting 0]

Hello EM1125,

Thank you for your response.

I started looking into the surgery 6 years ago going to a seminar. I then went to my Dr. (at that time) which told me he did not agree to the surgery.

I later changed Dr. this one agreeing and we started documentation. During that time my insurance changed and I was told I would have to change Doctors. I took all my information to the next Dr. once again this new Dr. did not agree with the surgery so I was back to square one.

I later found out I could return again to my last Dr. in which we started keeping records again. Several months into it I started having a lot of female problems they had become so bad that I stopped with the weight and started with getting help for female surgery. It has now been a year and things are going well so I went back 3 months ago to talk to her about getting things starter again where we left off with my weight program and she (my primary Dr.) told me I would have to start all over again! I told her this was ridiculous I have already played their games and she told me this is the way it works... I have since been back in the hospital due to now a heart condition! I am waiting to see a cardiologist. I feel these conditions (arthritis, high blood pressure, high cholesterol, acid reflex, and now recent heart condition... the next is diabetes, everyone of mothers side, grandmother & two uncles loss of limbs, two aunts blind all from diabetes) are being brought on by the weight, the yo-yo dieting roller coaster I have been on for the past 30 years.

I hope I have not lost you through all this long drawn out story but I am trying to help you better understand...

Thank you any help is greatly appreciated...

Hopefullystillinwaiting :thumbup:

[annsher10 0]

Emily,

That was 2 years ago... What happened???

I'm just starting the process now with Healthnet and my BMI is 37.8.