Question:
I just emailed someone regarding insurance laws in Indiana and I would like to know.

I would like to know if anyone here thinks that while I do not have a month to month account of weight loss history but I do have all the doctor notes from the time I started going to my doc and she has noted things concerning my weight and the need to loose weight and that I have tried and she has stated in letters to them that it is medically necessary, do you think I will be able to have the denial reverse if it was only based on the lack of month to month record? Next, how can I find out exactly who to contact about the surgery laws in Indiana? Thanks AMOS I love this site...God Bless to everyone...^j^    — Kimberly L. (posted on June 20, 2001)

December 13, 2001
The trouble with asking for help with insurance matters is that every state is different. You have to get the help from someone in your state who knows what is going on specifically in Indiana. Have you asked your weight loss surgeon's staff for help? Most surgeon's offices that do weight loss surgery have a person on staff who deals with these matters and knows the ins and outs for practically every insurance plan in your state. That person is going to be enormously helpful. Second, try to recruit the help of the state's insurance and/or health commissioners. In Minnesota, major medical carriers are under the control of the Commissioner of Commerce (insurance commissioner) and managed care plans are under the control of the Commissioner of Health. Health plans hate the heat they get from commissioners because they can be reprimanded or even fined for not living up to their responsibilities. Get in contact with these people. Finally, as another respondent indicated, if your employer is self-insured, they are under federal (ERISA) guidelines and can completely ignore state mandates for coverage. You should write your congression delegates (rep and sen) and tell them to support legislation requiring that self-insured employer plans follow the mandates of each state in which they do business. The ERISA laws are one of the great sources of evil in our society. Dr. Vance Rawlings
   — Dr. Vance R.

December 29, 2001
Also Kimberly, as far as your Dr is concerned it depends on how she chooses her words to document it. If she is in favor of you having it, then speak to her and clearly let her know what you are up against. At Winona and St Vincents they are pretty good about helping you gather the necessary documentation...or at least showing you the way. I would highly suggest you accompany it with a letter you have written yourself. The more detailed it is the better. If you are diabetic since you did not list any co-morbidities in your question, that counts as a diet to. Write down every diet you have ever been on in your letter along with amount loss and regained. Also did you check on the page for Insures of Indiana here on site, to see if others who have your insurance went thru any battles with that company..If not check it out and email those individuals specifically...I am sure they will offer any help they can. Hope this helps
   — [Anonymous]