I got some bad news today from my Drs office

I talked with Dr C's office today about my paperwork. She called me back about 2pm. She asked me if I had sent in all the info that Anthem requires. When we were talking about the 18 months worth of dr supervised dieting....I said something about well after July 1st I had heard u only need 6 months worth. She said that is only for the ppl that have the state as their insurance....like medicaid ect. So even though I work for the state...we have Anthem insurance and it doesnt apply to each insurance company.... Only the ppl that have insurance that the state pays for. There is nothing that says the insurance companys have to change what they require. This really Sucks becouse I figured if I got deniled I would be able to start over with a 6 month wt loss program... However 18 months just seems like forever. Mariah

I am sorry to hear that! Hang in there, keep on working toward what you want. If it helps any, I tried for 4 years to get my surgery. I finally got the job that had insurance that would pay for it, and was approved after my first letter. I am so happy to see people who are determined to live a healthier life. I thank God daily for my weight loss, and health! Keep the faith. Rhonda

huh? does your policy now require 18 ,months? not sure anthem requires 18 months, then again depends on the policey...but i would think your gonna be ok...

As you know I have Anthem and they require 18 months. Never in a million years did I expect to meet that requirement the first time. Have some faith and I think everything will work out for you.. Good Luck!!!!!

Hii !!! i just want to say don't give up , Anthem denied me last month because i did NOT have 18 months supervised diet with a Dr, so Amy at Dr Clarks office told me to right them a letter as to WHY i wanted it etc , so i did and she mailed it with her stuff and im approved . i no i didnt show 18 months worth of dieting with a Dr. so please dont give up .. You'll get approved .. just dont give in hugsss and prayers jenn

I work for Indiana Department of Revene.. STATE Employee.. I have Anthem... they didnt give me a hassle!!! Cross your fingers.. say an extra prayer... Remember good things come to those who wait.. Linda

Keep your head up and keep going, hopefully they will waive the 18 months, I was denied the first time by Cigna because I didn't have 6 months consecutive and we switch insurance as of 01/01/06 and I was approved within 2 weeks after that and had my surgery 2/21/6. I will keep you in my prayers.

Mariah, I'm not sure that your contact person at the Dr's office is correct. I believe the new provision applies to all health insurance plans covered by STATE LAW... not just those that cover state employees. I haven't researched this thoroughly, but if you get denied on this basis, send me an e-mail and we'll figure it out.

I do hope you all are right. I really really do. It shouldnt be this hard to get if u have co morbiditys. Also just for the record. I stated that it DOESNT cover state employees... everyone keeps saying that I said it only covers state employees. State employees are covered by Anthem!!! Sorry for the confusion maybe it was how I worded it. Mariah

The way it works is that these Indiana statutes apply to ALL insurance plans that are required to follow Indiana law - state employee or otherwise. I believe the changes were made in each of the various sections of the statutes that affect this mandated benefit. If you work for a company that directly sponsors and self-funds its benefit plan (and is therefore governed by federal law - ERISA - instead of state law), then these provisions would NOT apply to that health plan. ERISA plans do not have to follow state mandated benefits, including surgical treatment for obesity, and can exclude it all together or limit it however they want. So if you belong to an insurance plan that must follow state law, then the change in this provision would apply to your plan. Anthem administers BOTH fully insured (state law) and self funded (federal ERISA) plans - so it depends on what your plan is. E-mail me directly if you'd like to get into more detail about your plan.