Does anyone have HealthNet? I'm waiting for my approval. Surgeon's office sent it in a few days ago. I don't know how difficult they are. Let me know. Thanks.

Emily

Does anyone have HealthNet? I'm waiting for my approval. Surgeon's office sent it in a few days ago. I don't know how difficult they are. Let me know. Thanks.

Emily

I have healthnet HMO and have the same question.

Kit

I know this is an old post but I was wondering if Health Net paid with out giving you a bad time. I have Health Net and I have seen my pcp and he is sending me to see Dr. Ali I think he is out of the ucd site. I just hope they will cover me I can not pay out of pocket right know.

Hi brknbck,

I haven't been on this post for a pretty long time. Your response came to me via e-mail.

The answer to your question is absolutely yes!! They gave me a very hard time. I appealed twice and then I hired Kelly from Obesity Law. In two weeks it was overturned. Health Net will ask that you have atleast 6 months to a year of weight loss supervision with your MD. I had a year of supervised weight loss with a nutritionist and I went up and down in my wieight. They at first said my BMI was lower than the criteria, however, Kelly got that overturned because I also has other health issues, i.e. high cholesterol etc.

It was a four month process for me, but it was all worth it. I love my lapband. I am going on a year in September. I've lost 35 pounds which is not a lot in comparison to what others can do. I don't really diet, I just eat a lot less than I ever did.

Do what you have to do and if Health Net gives you a difficult time, appeal it and if need be hire kelly from obesitylaw.com. She was instrumental in the entire procedure. Any other questions, please let me know if I can be of any help.

Good Luck!!

Emily

Thank you for the info I guess I should get ready for a fight. Where do you live I'm in Camino, CA or as most people know it apple hill it's in El Dorado county. If they do not pay I will have to start saving the more I read on this board the more I know this is what I need.

No problem. I'm from Westchester, New York. Believe me, I wanted the lapband so badly, that I was self pay right up until 3 days before the surgery. That's when my appeal was overturned. Thanks to Kelly from obesitylaw.com.

Good luck and best wishes to you. Let me know what happens with Health Net.

Hello All,

I had signed on here a couple of years ago as Hopefullyinwait now Hopefullystillinwaiting

I have been looking into having surgery for about 6 years now. I was putting my time in as Health Net requires, I had about 8 months time in but became very sick from female problems. I had surgery for that and now that I am ready to get started again with the weight loss my Dr. now tells me I have to go through all their games again! She says it is due to the insurance co. Does anyone have any information on this... I was trying to find out information when it sent me to this site... I am hoping the one who started this page was blessed with your surgery and is now health, slim & trim:thumbup: I would love anyone's help if you know of any Dr. that do not make you play all the games as mine is saying nessesary to do again. I have many health problems and they seem to be adding up as time goes on. It hardly seems fair that I should have to play any longer, 6 years is more than enough. Living in High Desert Apple Valley, Ca area.

Thanks to All...:cool:

Edited November 15, 200817 yr by hopefullystillinwaiting
adding old e-mail name

hopefullystillwaiting,

I don't understand. Your doctor is telling you that you need to go through this again. That doesn't make sense. If you have been struggling with your weight for six years and have a lot of it documented then you shouldn't have a problem. Where are you from? and Explain who is telling you this. Your doctor or surgeon? Is the eight months of documented supervision recent or from six years ago? I'm a little confused as to why they don't try to put it into your insurance to see what happens.

Hello EM1125,

Thank you for your response.

I started looking into the surgery 6 years ago going to a seminar. I then went to my Dr. (at that time) which told me he did not agree to the surgery.

I later changed Dr. this one agreeing and we started documentation. During that time my insurance changed and I was told I would have to change Doctors. I took all my information to the next Dr. once again this new Dr. did not agree with the surgery so I was back to square one.

I later found out I could return again to my last Dr. in which we started keeping records again. Several months into it I started having a lot of female problems they had become so bad that I stopped with the weight and started with getting help for female surgery. It has now been a year and things are going well so I went back 3 months ago to talk to her about getting things starter again where we left off with my weight program and she (my primary Dr.) told me I would have to start all over again! I told her this was ridiculous I have already played their games and she told me this is the way it works... I have since been back in the hospital due to now a heart condition! I am waiting to see a cardiologist. I feel these conditions (arthritis, high blood pressure, high cholesterol, acid reflex, and now recent heart condition... the next is diabetes, everyone of mothers side, grandmother & two uncles loss of limbs, two aunts blind all from diabetes) are being brought on by the weight, the yo-yo dieting roller coaster I have been on for the past 30 years.

I hope I have not lost you through all this long drawn out story but I am trying to help you better understand...

Thank you any help is greatly appreciated...

Hopefullystillinwaiting :thumbup:

Emily,

That was 2 years ago... What happened???

I'm just starting the process now with Healthnet and my BMI is 37.8.