Priority Health - ****hanges for 2007 ???

http://www.priorityhealth.com/employer/news/newsletters/Priority_at_Work/2007_issues/Sprin g/coc Am I reading #3 correctly? PH will now approve WLS? There's still got to be a catch. Has anyone tried to be approved with PH since Jan and can give some insight?

 

If you go to that link I posted above, The Priority Health Certificate of Coverage (**** lists several changes that were in effect as of Jan 1, 2007. #3 states several Surgeries that are now covered including Bariatric and pannilectomy (SP?). My primary doc thinks I would be a good candidate for WLS, but last year when I went through pre-approval etc, Priority denied me even though my BMI was 49.5 and I had diabetes, hypertension, and high cholesterol. They said my co-morbidities weren't severe enough, even though my BMI was high. I can't afford to do the 6 months of protein fasts that PH sometimes requires. Now my doc has referred me to a sleep study because he thinks I have apnea. I was just wondering if anyone knew from experience this year if PH is easier to work with than in the past. I would love to know if they approve you or not, and if not what their reasoning is. Do you mind telling me your BMI and your co-morbidities? You will like Dr. Foote. I have 3 family members who have had surgery with him and they were very happy. My cousin lost over 100#, my aunt is still losing, and my cousin's husband just had surgery 2 weeks ago and is doing very well. In the mean time I am trying to lose weight on my own.