I tried searching for this question in the forum, but I want a more recent answer, if possible.

My PCP said that she would write me a letter of medical necessity for the surgeon/insurance if need be to help me get qualified for WLS as well as provide any records of mine where she was monitoring my use of prescription appetite suppressants. Does anyone think the insurance would accept this instead of needing to spend 6 months trying another failed diet again?

I know insurance companies will always err on the side of not having to pay for surgery, but I'm just curious if anyone got past that 6 month supervised diet with a note from their PCP before.

Mine will end up being 6 mos total. Feb-Aug.

8 hours ago, PENGU1N said:

I thought about doing this, but every time I call my insurance I get the most useless people that don't seem to want to help or just don't even know. I may still give it a shot, though, thanks.

It is terrible getting info out of insurance reps. Ask for someone in the prior authorization department. Good luck!

On 08/09/2018 at 16:07, PENGU1N said:

I tried searching for this question in the forum, but I want a more recent answer, if possible.

My PCP said that she would write me a letter of medical necessity for the surgeon/insurance if need be to help me get qualified for WLS as well as provide any records of mine where she was monitoring my use of prescription appetite suppressants. Does anyone think the insurance would accept this instead of needing to spend 6 months trying another failed diet again?

I know insurance companies will always err on the side of not having to pay for surgery, but I'm just curious if anyone got past that 6 month supervised diet with a note from their PCP before.

I say test your luck. I only turn in letters to my insurance and got Approved right away. A letter from my PCP, Endo and I wrote my own diet letter saying i was on phertamine. I know it sounds crazy but in less then a month I was approved and had my surgery.

I started out doing the 6 months of visits because my surgeon’s office thought that was required w BCBS, but...after about three months of visits, the office checked for someone with the same type of insurance I had and that rule had recently changed, and I found out today that I am approved for Sept 12! I say go ahead and have them submit your packet with the medical necessity letter and your clinicals, and then your doctor can even speak with the nurses reviewing your file to plead your case. The worst they can say is that you have to do the full six months, and hey- if you don’t ask, you don’t get. Go for it!!

Edited August 14, 20187 yr by misschrisdallas