Question:
Help! M-Plan wants 18 CONSECUTIVE months physician supervised diet, what to do?

Oh my goodness, after speaking with my insurance company today I was informed that I needed to prove 18 CONSECUTIVE months of physician supervised dieting. I don't have that! They said the whole time I was doing Weight Watchers, Jenny Craig, Nutri System, blah, blah, blah, I should have ALSO been seeing my pcp and having him weigh me. Good Lord! Who goes to their pcp once a month for 18 months? What do you all suggest??    — Martina B. (posted on February 21, 2006)

February 21, 2006
unfortunatley this is what the insurance companies are asking for now days. a lot of insurance companies will only ask for 6 months. I would talk to your PCP and ask him if he can help you out. If you have HBP, or bad diabetics, he might be able to write some letters for you. good luck
   — Steve Cohen

February 21, 2006
I am sorry you are having trouble with your insurance company. Mine wanted a year of supervised visits but what I did was go for about six months and then I wrote an appeal letter to be included with the papers my WLS re-submitted. My PCP also included a letter in the paperwork. This is just a suggestion. Good Luck. Laural HW-313, SW-292, CW-204, GW-135
   — Laural D.

February 21, 2006
Martina that is so unfair for you. I am so sorry. What I would do if I were you would be to maybe have your PCP wrie a letter that says something like .. following my advice Martina worked with weight watchers.. Jenny Craig.. whatever for the past X amount of time.. with no sucess. At this time I feel gaastric bypass is in her best intrest. Or something like that that states he/she was aware of the fact you had been to these places with no success. I'll keep my fingers cross and say a prayer. Good luck friend! Kim
   — KimY

February 22, 2006
A lot of Insurance compies are taking people through this long extensive waiting period not to mention it cost more doing it this way. I was lucky enough not to have to do all of that and basically I had the referral from my Dr and set the appt with WLS and was on my way. Hang in there, it will be worth it. Tarla
   — tarla_r

February 23, 2006
hello- I am also waiting to get my surgery and have to wait 6 mos. before the insurance company will do anything. I spoke with my bariatric doctor who said that only within the last 6 mos. have the insurance companies began to crack down and now are requiring much more. So, if you look at people's success stories before 2005, you'll see that it may have happened very quickly for them. I know that this really sucks! It's like they want us to go on a diet and fail, like we've never done that before! It's also really stupid because, obviously, this is a medically necessary procedure and baisically they are just making people more unhealthy by making them wait longer for surgery. I hear your frustration, just hang in there. The first thing that I would do is call your doctor (PCP) to see if he can do anything for you. One of the girls that I know showed her diary to her doctor, who was then able to send a letter to her insurance company. Her diary had her diet plan and a diet diary in it and this was good enough for him and the insurance company. That may be an idea. Good Luck! --Amy
   — amysocko

February 23, 2006
Thank you, thank you for all of your wonderful support and ideas! It helps a lot to know that I am not in this battle alone!
   — Martina B.

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