What should I do??

I am in a dilemma.. Currently I am insured with Kaiser Permanente; however, eff. January 1, I will be insured with BCBS-HMO. Whee!! (finally). I want to start doing something to speed the WLS process along but what can I be doing? I can't start the tests because Kaiser won't cover/pay for anything connected with WLS. I won't be able to use my selected PCP until January so I can't use him for anything? So what shall I be doing for the next 2 months? I have been a lurker for over a year and I know you guys give good advice/information ... so please help me out! Thanks.

hey - you might want to check out bcbs's new wls policys!! they have gotten in a bunch of pig heads in there and are making things alot more difficult for those of us that need/needed wls. they still cover the surgery it's just alot more difficult to qualify now. -32 lisa s

Lisa, What has changed? My Certificate booklet just says it must be "medically necessary". Do you know the requirements? Thanks.

really all you can do is i think is see if you can get a referal and if you can then you can start things but to be honest i think you have to wait until your insurace is effective for them to pay for anything .....sorry !! Laura

I would start drafting your letters now. Letters such as, failed diet history, weight loss history, and even a Medical Clearance and neccessity letter for your PCP to sign. I'm not sure what BCBS-HMO requires. Maybe check the "insurers" link and see what other requirements. Sometimes they require a 6 month Dr supervised diet & weight in. You may want to start on that if it is required. Just a few suggestions. Hang in there. Tonya

Begin to document your struggles in concrete ways....dates, etc. of WW, other diets. If you have documentation from your previous PCP for things relating to obesity. If you have an othopedic doc. or cardiologist that would write you a letter, get that out of the way, as well. Our medical records are ours, aren't they? I would expect you should be able to get copies of all your prior visits to your PCP's. Those that relate to weight issues, joints, sugar, blood pressure, should be included in your documents. I would expect that your whole file could be forwarded from your last PCP to the current one that you will see in January? That history will follow you, then it won't be like you're starting to document your journey from day l. Good luc****ep us posted.