Help...need suggestions...
Hi everyone....I went for my first consult last week.....and now I need some suggestions. I was told that I need to have my PCP write a letter of necessity to to the insurance company to try and get the surgery approved. So, I really don't think he will ....he does not believe in diet pills, so I assume he will turn me down on the letter. I could not get an appointment with him until April 4th, so I am hoping for some ideas on how to convince him before then. I don't have any major medical problems....HTN, diabetes, etc.....YET................so I wonder if the insurance company could refuse me for that alone. I am 5'6 and 300 pounds, so my BMI is considered in the needed range. I only see my doctor when I am sick, so I don't have much medical history......has anyone else faced similar problems? I have Aetna insurance....anyone have experience with them? I feel so desperate....I really need/want to have the surgery....I feel it is my last hope...and to have the insurance company in charge is so frustrating! Everyone out there who has gotten this approved ...you are so lucky!!!!!
Mandy, does you policy have WLS as a covered benefit? That is one step for you to find out if they will cover and what their requirements are, ie; 6 month supervised diet trys or a 5 year history of being obese, co-morbids. you should have your blood work done to have an A1C to see what your accumulative blood sugars have been for the last 3 months. You could be type II and do not even know it. That is how it was found on me. You are saying that he does not believe in diet pills that may mean that he will be for WLS. He may first encourage you to try conventional methods first so it is documented and then he may write your letter. If he says to you why have you not been in then explain to him why you have not come to him for weight loss issues, say for example tell him that you are not a person to come running to a doctor to get help with weight loss, you are a private person, but you have been trying to loose weight for years. If not then you may need to change to a WLS friendly PCP. That is about all that comes out of my pea brained head at 530 in the morning. Chris ps do not think negative thoughts, be positive because then you will come across positive.