What's up with this insurance?

[marylee 0]

I called my insurance co. and they told me they approved the Lapband but when I went to the surgeon's office they said my insurance company has a stipulation that I be on a medically supervised weight control program for 6 months. I've been going to Weight Watchers for almost that long. Shouldn't that count? Does anybody know of a way to get around that? It took me long enough to decide to get the surgery to begin with!

HELP!!!:cursing:

[newimage 2]

I would call your insurance co. again and ask what the stipulations are...if any. Good Luck!!

[Wheetsin 714]

I've been going to Weight Watchers for almost that long. Shouldn't that count? Does anybody know of a way to get around that?

Weight Watchers won't count as a medically supervised diet, and shouldn't count, because it's not medically supervised. Medically supervised means that you are going to a physician for the sole purpose of weight management, in which case you will have a lot of medical paperwork to back you up (even when the physician refers you to a dietician). A lot of people think having gone to the doctor in the last 6 months, and have a record with their weight on it, will satisfy this requirement but unfortunately they find it does not. In fact, believe many insurance companies look for specific coding related to treatment of morbid/obesity.

I understand what you're going through. You've made up your mind and want an instant reward. I don't know too many people who haven't been there in some way or another. I was very glad when I learned I didn't need the 6 mos (assumed I would), but looking back -- it's really not a bad requirement to have in place.

[NYGMEN 0]

I asked the same thing last year and from i had to do I would say no. there is no way around it. I had a BMI over 50 and 4 very bad disks in my neck and back and well as sleep ap. I also had to have my ACL replaced because i blow it out. They didn't want to know anything until the 6/mo dotor diet was done. I could have been on my death bed and they wouldn't have approved it until that was done..

[pearlygirl 1]

My insurance does accapt weight watchers, jenny craig etc. Call your Ins company and see what they say, it's worth a shot.

[Aquameliza 0]

My insurance does accapt weight watchers, jenny craig etc. Call your Ins company and see what they say, it's worth a shot.

What insurance do you have pearlygirl?

Aquameliza

[pearlygirl 1]

Aqua - I have Lumenos. They don't require MD assisted, just well documented.

[krazygrl77 1]

A lot of times its not the insurance it's the doctor that wants you to do the diet. I would call your insurance and make sure it isn't in your plan and that maybe the only way around it.

Because my BMI is over 40... i don't have to do one for insurance purposes. It's worth a check. Good Luck!

[aronson333 0]

Do you by any chance have Horizon BC/BS? That's what I have and I too have been told they require 6 months of a program before surgery - and, depending on your BMI - 2 years proof of a weight loss program. The weight watchers may count - I'm just getting into it myself and I'm worried about the 6 months since I have back problems and am possibly facing back surgery unless I can get the weight loss surgery faster and hope that the loss takes care of the back problems.

Anyone out there have any dealings with Horizon and any suggestions on moving them faster than the 6 month "rule"?

[aronson333 0]

Why did Aetna refuse your surgery?

[MicheleK 8]

Aetna required a 3 month diet for me. I went to the nutritionist 4 times and just got the paperwork submitted today.

It sucks having to wait, especially since I've spent pretty much the last 15 years doing nothing but dieting off and on, lol.

Hang in there! It'll be worth it...it just sucks waiting especially when you have issues needing to be handled.

[alteration 0]

does anybody know the procedure about uhc? i heard that they dont make you go through this long process with the supervised diet and all.:Angel_anim: