HealthNet Supervised Weight Loss Requirement

Does anyone have any experience with HealthNet's requirement for 2 years of inability to lose weight or regain it and 6 months of supervised weight loss? If my surgeon has documented my attending Weigh****chers since January 2007 and Surgery is planned for April or May 2007 (ie 4-5 months into the 6 month supervised diet), will HealthNet be sticklers and not approve it until a full 6 months' of dieting history is on the books? Is it OK for my surgeon to be the one documenting this? Thank you Lisa Proffitt

I'm not sure how your policy reads but mine had to be supervised each month witha visit to the doctor, even if going to weigh****chers I still had to go each month to see my doctor goe over my progress and my plan to continue weightloss. Here is how my policy reads. 

• Medical record documentation of active participation in a clinically-supervised, non-surgical program of weight reduction for at least 6 months, occurring within the twenty-four (24) months prior to the proposed surgery and preferably unaffiliated with the bariatric surgery program.  [NOTE: The initial BMI at the beginning of a weight reduction program will be the “qualifying” BMI used to meet the BMI criteria for the definition of morbid obesity used in this policy.]
• A program will be considered appropriate if it includes the following components:
  1. Nutritional therapy, which may include medical nutrition therapy such as a very low calorie diet such as MediFast or OptiFast OR a recognized commercial diet-based weight loss program such as Weigh****chers, Jenny Craig, etc.
  2. Behavior modification or behavioral health interventions.
  3. Counseling and instruction on exercise and increased physical activity.
  4. Pharmacologic therapy (as appropriate).
  5. Ongoing support for lifestyle changes to make and maintain appropriate choices that will reduce health risk factors and improve overall health.

Hope this helps you. I have the form my doctor used scanned into my computer if you like I can send you a copy, just send me you email address. lol Jen

"Weigh****chers is not really medically supervised." - While Weigh****chers is not medically supervised in and of itself, many insurance policies are now accepting it as a program if your doctor recommends it and you see your PCP each month as well.  The Weigh****chers program has all elements - dietary, exercise, counseling.