New Insurance Requirement

sarcar · May 29, 2005

I've been fighting with the Insurance company (First Health) since March. They originally sent a list of criteria that I met. Then they came back and now say I have to go on the diet I will be on after the surgery for three months. According to my doctor, it looks like several insurance companies are going that way....so be prepared.

I've met the first list of criteria, so after I do this diet for three months, I hope to be approved and on my way to losing.

Carolyn

kimmcneely · June 10, 2005

According to my doctors office my insurance (BC/BS) wants you to be on a 12 month medically supervised diet and exercise program.

sarcar · June 10, 2005

Mine originally said that I had to be on a diet for at least six months out of the last two years that was doctor supervised. Now they are adding three months on the diet you will be on after the surgery. This 3-months has to be within the last 6-months. This 3-month diet also has to be dietician and doctor supervised.

Mita · June 10, 2005

Mine had me show 6 months proof of being on WW.

Jasper · June 10, 2005

With my insurance you had to lose 5% of your body weight before surgery.

Mystyblu · June 18, 2005

My ins co (Atena) is requiring the 6 months of Dr supervidsed diet & exercise plan. If all goes well and there are no additional requirments that will put my surgery in Jan or Feb of next year. What a way to start out the new year !!!

July 3, 2005

I live in the state of MA and I heard of the lapband through my Doctors who seem to think that the state of MA will pay for this operation. I am truly over weight, can hardly walk now and have high blood pressure,diabetes & high cholesterol. I only have Mass health insurance. Anyone ever have the state pay for this?

Thank you,

Tpreciousheart · July 6, 2005

I've been fighting with the Insurance company (First Health) since March. They originally sent a list of criteria that I met. Then they came back and now say I have to go on the diet I will be on after the surgery for three months. According to my doctor, it looks like several insurance companies are going that way....so be prepared.
I've met the first list of criteria, so after I do this diet for three months, I hope to be approved and on my way to losing.

Carolyn

I have first health as well, with the same requirements, clearance for pulmonary and cardiac, meet with detitian, 3 mo medically supervised, exercise and behavior therapy modification. Psych eval. ETC.

My problem is that i forgot to go weigh in in May, So I wonder if this is a problem I say My PCP started the diet, exercise and behavior stuff in April, but failed to see her in May, say her in June and have another appointment in July.

What do you think. Do you have to weigh in every 30 days?

sarcar · July 6, 2005

I started this new eating the way you will after the diet in early June. I just went in and weighed yesterday for the first time and they are telling me that August will be last time I have to come in weigh. I also am working with a Private Workout plan designed by Cooper Institute. I'm hoping this is the last of it (I wish I wish). So I will have to come back in early August for my final weigh in. Your PCP should be able to help you through this. What state is your First Health through?

Tpreciousheart · July 11, 2005

Sorry it took so long been on vacation. I am with Mailhandlers-first health in KCMO. I weighed in April skipped May and weight in again in June, so I hope this will work. Hope you have much success. The criteria does not say you have to weigh in each month, but just a 3 month diet! Hope they don't change this at the last minute again!

Good luck 2 you!!

lorak2000 · July 25, 2005

Any experience with this company ladies?

I'm having my psych exam and nutritional counseling next month as I know this is one of their requirements.

I'm diabetic so haven't been on a supervised weight loss program however my blood sugars were running perfect, so obviously I've been eating right. I sure hope I don't have to wait another 3-6 months for this!

Laura