Weight Loss Surgery If you've had it, or are considering it, share your discussions here

Closed Thread
 
Thread Tools
Old 01-17-2003, 04:36 PM   #1  
Junior Member
Thread Starter
 
clkchef's Avatar
 
Join Date: May 2001
Location: Tampa, FL
Posts: 28

Default Insurance Company - vent

I called our insurance company today and they cover WLS if it is medically necessary. Medically necessary is determined by 5 years of being morbidly obese and having at least 6 consecutive months of medically supervised dieting.

The catch is that they don't cover the medically supervised weight loss programs. So I have to try to figure out how to afford that - there's a bariatric physician here in town but it costs about 100 - 125 per month depending on what medication she prescribes.

Then there is the hospital program - but it is 200 a month for the medical supervision and 92/wk for the nasty food they want you to eat.

Which would be fine if I didn't have to feed anyone but me. But how exactly do I spend 400 a month on food for me and then groceries for dh and dk????

This sucks!

Can't have WLS until I've been on a medically supervised diet but I can't afford the diet because it isn't covered by my insurance and in the mean time I just keep getting fatter, more depressed, more frustrated and less healthy.

The really annoying part is the usually Aetna does cover med. supervised wt. loss - but dh's employer specifically excludes them.

I'm frustrated!
clkchef is offline  
Old 01-17-2003, 04:52 PM   #2  
she who must be obeyed
 
debkay's Avatar
 
Join Date: Sep 1999
Location: Snellville, Ga (suburb of Atlanta)
Posts: 1,113

Default

Don't fret Carole, usually all the insurance company will require is that you go on a "diet" and weigh in once a month or every two weeks at your doc's office and have it recorded in your file...........that's medically supervised Are you thinking they require, Optifast or something similar??

Debbie
debkay is offline  
Old 01-17-2003, 05:23 PM   #3  
Member
 
newchickontheblock's Avatar
 
Join Date: Dec 2002
Location: San Francisco, California
Posts: 42

Default

If you ask your primary care physician for a diet usually s/he will comply. Go to their office every few weeks to be weighed and that should satisfy it. Several people I know did the "medically supervised" route this way. Check with the insurance company to see if that is okay.

Essie
LAP RNY 1/6/2002
12 lbs gone!
newchickontheblock is offline  
Old 01-17-2003, 06:05 PM   #4  
Old Cackler
 
jiffypop's Avatar
 
Join Date: Apr 2000
Location: northern New Jersey
Posts: 7,525

Default

yep!!! agree with these two wise women... all that REALLY has to happen is that the doc tracks your weight and that you do somethiing that the insurance company finds acceptable. and you might be wise to keep food and exercise logs to show your doc that you're really doing it. otherwise, there's the risk that they'll consider you a noncompliant patient, and there goes your chance!!!
jiffypop is offline  
Old 01-17-2003, 08:09 PM   #5  
Member
 
1 of our fat people's Avatar
 
Join Date: Jan 2003
Location: southwest virginia
Posts: 56

Default

Carole,
Last year I went to the doctor for the newest diet pill... and we discussed gastric bypass. She told me that the ins. company would probably want me to try everything else first, because, like your's mine doesn't cover any weight loss except surgery! So, I spent like $100 for a month of Meridia... Guess what... it didn't help a DARN bit! So, here I am about nine months later with a referral and appt to a bariatric surgeon for bypass surgery!

I agree with the others. Just go to the doctor and get a diet plan. Do the best you can, just to show them that you've tried. That should probably do it!

Patty
1 of our fat people is offline  
Closed Thread

Related Topics
Thread Thread Starter Forum Replies Last Post
Health insurance, big slap! friendlykat4u Weight Loss Support 20 02-01-2008 11:00 PM
Need To Vent... Trixie14 Weight Loss Support 30 06-03-2006 10:21 PM


Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off



All times are GMT -4. The time now is 01:26 AM.


We are a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for us to earn fees by linking to Amazon.com and affiliated sites.
Copyright © 2024 MH Sub I, LLC dba Internet Brands. All rights reserved. Use of this site indicates your consent to the Terms of Use.