[starting_over]

I am going to the doctor on Monday and I want to get everything checked out, (my thyroid, sugar, cholesterol, etc...) and I also want to talk to my new Dr. about me dieting and losing weight.

I was *thinking* of talking to him about medications to help with the weight loss, but I'm not sure if my insurance company would cover it or not.

I was just wondering, for those of you who have been on the meds...

Were you able to be on the meds without your insurance co. giving you a hard time about it? Did they cover your dr. visit & meds???

I have PPOM for insurance and I am just afraid that they will try to deny coverage. I was reading their policy book, and it says that they do not cover visits to the doctor for treatment of obesity/nutrition counseling. But when I look at their list of types of medications that they do not cover, obesity meds were not on the list. I wonder if this means that they would cover the cost of the meds?

Any thoughts? I am just concerned...
Thanks!
- Kari

[marbleflys]

It may qualify as a medical neccessity, depending on how your doc. words the DX.

I'm on both meridia and xenical......yes, it helps and my insurance covers both (my co-pay for meds is $5.00)...BUT..if you go the drug company's website, I know that at least meridia offers coupons IF you present them at the time you fill the scrip. (40% off I think).

[starting_over]

That is good to know

So I am assuming that some insurance's will cover it if it is a 'medical necessity' ???

I would be thrilled if they would cover it! My co-pays are $10 for name brand $5 for generic and free if I send the prescription in by mail....hmmmm....

[theotherjen]

I asked my doctor to prescribe Adipex for me after watching my best friend lose 60lbs in the same time it took me to lose 30 and I got a little disheartened. I have only been on it a week, but my insurance covered most of it. I have BCBS of CA ands its a PPO.

You can see if your ins. company has a website. They usually have a site for your pharmacy plan (at least mine does) and it will show you what is and whats not covered (and why).

I just went to my gen. practitioner and asked her about it and it all kinda fell into a regular office visit I just paid my $15 co-pay, I don't know about obesity/nutrition counseling...it would be nice, but I doubt it. I was worried about the prescription and if it would be covered. The generic (phentermine) was and I paid $10 for them. I had a hard time understanding the insurance lingo but I eventually found where to calculate the co-pay. But there should be a dispute process and I think that if your BMI is up there, they should be able to make an exception...my best advice would be to call them or to check their website to see about how Obesity meds are covered.

I hope this helps...you can PM me if you need to

[Solus]

It depends on your insurance company. Mine would not cover them even though for me they were considered a "medical necessity" because I am morbidly obese. I paid for a month out of my own pocket and tried the drug my doctor thought would help me best. It might have eventually helped me lose weight because it made me violently nauseous and I couldn't keep anything down for 2 days. Tried taking it 3 times with the same effect every time. We were going to attempt a different type but it was going to cost over $130 a month to fill. I decided lose the old fashioned way (healthy eating and exercise) and that has worked rather well for me thus far.

[starting_over]

Yikes - what a bad experience you had Solus! I would like to try the meds to see if they help...but if I get any bad reactions...I will quit. (That's if the insurance covers them!)

Thanks for all the friendly advice everyone. I will make sure to check out the website and see if they have a section showing what is covered.

Thanks again!

- Kari

[marbleflys]

It's a BIG difference in generic and brand prices.....I do believe that Xenical may be out in a generic form within a year? (don't quote me....this info. comes from one of my pharmacy students)...I don't know about Meridia. Because of my other "ailments", my doctor would not give me Adipex.

[thinthinker]

Kari: You might want to check out the Buyer Beware section of the site. Lots of good write ups about diet pills and suppliments. http://www.3fatchicks.com/forum/forumdisplay.php?f=11

[starting_over]

Thanks for the link thinthinker - I will check out the link you provided. I'm not 100% sure if I even want to be on pills after talking about it with my fiance' last night - but I thought that I would talk about the effects of it with my doctor anyways.

[DoxieMom]

I've thought about the pills myself, so I talked to my doc about trying some. He said absolutely not. He would not prescribe them, nor would he support me taking them.

I can tell you to do a full scale research project before taking any of them. Unfortunately I have worked in the legal field so long, I think I have become synical! When the Phen/Fen craze was out, my doctor refused to give those to me too - now I'm glad he did. I have seen the in-depth view of too many lawsuits over those drugs, and this was AFTER the FDA approved it! All I can say is be careful and think it over carefully. Good luck!

[starting_over]

Thanks so much for the reply DoxieMom.

Wow - I guess I never really thought about the past diet pills & the effects that it has had on people. I've been doing some reading on the internet about Meridia and Xenical.

I have used Xenical (many years ago) and had very bad experiences with it. (Not my cup o' tea!)

After reading the Meridia website, you'd think that this drug is for you, but then I have read about some of the side effects. Some weren't bad, others could be unknown. (Espcially if they are uncertain that it could cause heart valve problems...which just so happen to run in my family.)

I think that when I go to the doctor on Monday - I am just going to do my check-up as planned, and discuss with him my plan & my eating habits. I don't think I am going to persue diet pills.

Thanks for all of the very helpful replies!
You are all wonderful!

- Kari