6 month supervised diet WTF !!!

I have been under the same doctors care for the last 11 years.. thru all my dieting crap Jenny Craig, WW, Diet Pills, trainer, Atkins, Nutrisystem.. etc .. And now I have to do another 6 months supervised before I will even be considered for surgery ??? WTF ??

There should be a law against Insurance stall tactics !!

It is a stall tactic. If you're willing to appeal to your insurance company you can get around it.

You can either file the appeal yourself or you can have someone represent you and write the letter on your behalf. You have to establish medical necessity and meet whatever criteria your insurance company requires such as a high BMI and whatever comorbidites you might have.

The insurance company will also look at your medical history with your doctor. Make sure your doctor has documented over and over again all the attempts you  made to lose weight.

If you are denied in your appeal you can then appeal to the Depeartment of Managed Healthcare, the governing agency for all HMOs that operate in the state of CA. They are on the patient's side and understand that insurance companies will sometimes use stalling tactics.

If you'd like you can consult with my attorney, they were affordable and awesome!! www.obesitylaw.com

Good luck to you!

I had to do it too because my insurance required it.  It actually went by pretty fast and I learned quite a bit.  I agree with Monica above though, I think folks can appeal it.

Good luck to you.

Ugh. I replied to your post after taking my pain meds. I wasn't lucid.

Sorry. :(

Please contact me if you have questions.

Your doctor should be able to document that for you for submission to insurance company.

Please appeal. Many insurance companies will reject and stall claims knowing half of the people won't question it. It's a money saving tactic.

There is a good reason to lose some weight before surgeyr if you can. If your liver is fatty, it can bleed and even fall apart during surgery because they have to move the liver to do the surgery. Just losing 5-10 pounds can help your liver.

Good luck! Give 'em hell!

MsBlues

Definitely appeal this.  Do everything the posters above me said to and fight this.

Having said that, you may want to go ahead and jump through their hoops while you are appealing it.  Start whatever silly program they have in place.  I had to do one that was just ridiculous.  They sent me a ton of books, exercise bands, a pedometer, etc, all paid for by the insurance company.  Then once a week I had a half hour phone call to see how I was doing.  It was absurd, but I did it, because I figured, while I was fighting this, six months was going to pass anyway.

Five months into the six months, I received a phone call saying the insurance company was no longer going to require this!  Ugh.

BUT, things happened very quickly and I had my surgery less than two months later.

Fighting it may take some time and you should be able to win, but if it takes 6 months to fight, why not go ahead and do their program just to make sure you get this surgery.

Just my humble opinion.  I wish you good luck and PLEASE keep us posted.