Anyone have HealthNet Healthy options??
Wow what a Day. I heard from Louise and she said that it all looked pretty good and that I might be able to go in for the 17th of this month so I GOT ON CLOUD 9 so excited. THEN BOOM she called me back and said that ALL OF A SUDDEN HEALTHNET said that you have to go on a 6 month Dr approved Diet and be watched by a Dr for the whole time and then have the notes from your Dr sent over to them and THEN AND ONLY then will they decide!!!!!!!!!!
ARGHHHHHHHHH I am sitting here balling my eyes out as I was so excited JUST TO GET SHOT DOWN.. So of course now I am saying OK I guess I was meant to BE FAT AND NOT BE ABLE TO BREATHE.
I am so upset... Totally ruined my weekend.
So I called Healthnet myself and she said Maam I just customer service I have NO CLUE what they Authorization requirments are for that. You would have to have DR call for you as they will NOT speak to patients.
So I called my Dr to try to get him to write something up saying that he has seen me all along and that I need it etc... and the office is CLOSED already so here I still sit CRYING..
WHY ME???????????????????
I GIVE UP!!!!!!!!!
LISA DONT GIVE UP...CALL YOUR DOC ON MONDAY AND HAVE THEM SEND SOMETHING IN TO YOUR INSURANCE SAYING IT IS MEDICALLY NESCESARY FOR YOU TO HAVE THIS OPERATION ALONG WITH ANY MEDICAL PROBLEMS THAT YOU MIGHT HAVE....I DONT KNOW HOW HEALTHNET WORKS BUT I HAD CONNECTICARE AND THEY APPROVED ME LIKE 3 DAYS LATER PLUS I HAD A LETTER OF MEDICALLY NESCESITY TO GO ALONG WITH IT.......
KEEP FIGHTING IT AND I WILL KEEP YOU IN MY PRAYERS.....
ANNETTE
1WK POST=OP
Annette,
Thanks so much for responding to me hon.
I wasn't even aware that you went in. How did it go? How do you feel now?
I am just so upset and feel like i have just been so let down. I am going to call the Dr on Monday as I have a medical condition called Pseudo Tumor Cerebri and that (my neurologist said) is usually most popular in obese people. I am 255 now and wasn't even that heavy when I saw him. This can cause me to go blind if I don't loose the weight. I have tried so many diferent things and I am STILL taking Xenical with NO LUCK at all. Arghhhhh..... I just want to scream..
So sorry to be so negative and down.
Thanks again And I hope you have a speedy recovery and feel GREAT!!!
Lisa
Don't give up Lisa. You will find a way to get this done. It sounds to me like you should call your Dr. and have them speak to your insurance company to appeal. I bet you won't have any trouble at all appealling as it sounds like it is medically necessary.
I had Healthnet when I had my surgery done, but my surgeons office says things wouldn't be so easy for me if I was going to have the surgery this year they have gotten a lot tougher.
Hang in there, it will happen.
Maggie 
Lisa:
Don't get too upset. It will all work out. How long have you been on Xenical? Can't that time be applied towards the 6 months requirement? Call the Dr. on Monday and see what they can do for you. I would also call back the insurance company and speak to a supervisor. They need to be able to tell you what the requirements are. I used to work for Blue Cross. They should not tell you they don't know. If they don't know they need to find out & get back to you. Don't let this spoil your weekend. I know it is easier for me to say than for you to do but it will work out. I am sorry you have to deal with this.
Best of luck to you.
Chryssie
That's total BS Lisa. The insurance company HAS to be able to tell you what the requirements are. And they DO talk to patients and HAVE to talk to patients and explain them to them. My Mom works for Aetna, so I usually ping my insurance woes off of her. She said if you are denied, etc. or they make a decision you don't like you have the right to have a peer to peer review and have the medical director review your case with your doctor. Don't give up!
Erin
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