New Law Regarding WLS??

Hi Everyone! At my last visit with my nutritionist, she told me that the law had changed and insurance companies cannot withhold bariatric surgery longer than 6 months. My insurance company - MPlan - was making me do an 18 month MD supervised diet with monthly MD visits and nutritionist visits and I have to be involved in a program which I chose to use Weigh****chers. I am so happy because now I qualify for surgery in July instead of October even though I've been on this program for 15 months in July. I guess the law isn't retroactive! I am so excited! My psychiatric eval is May 26 and I am on my way! I was wondering if anyone else had heard of the change?

Yes, a while back someone who was a health insurance attorney, who is also looking into wls, and fighting with her approval, had posted, that in July 2006 the Indiana law would change to no more than 6 months prerequisite and that it would be retroactive, so that anyone who had already started preparing for their journeys that this time would count toward their 6 months!!!! I printed this out and had it at the clothing exchange for anyone who needed to see it. I kept a copy of itfor some friends of mine who also are struggling with m-plan, I personally think that anyone who wants this surgery should be allowed to have it, luckily my insurance company was GREAT, from initial consult to surgery (original date) was only less than 3 months, I think making people wait what seems to be forever is not acceptable, and am very happy to hear that things are changing and now my new sisters and brothers in wls will not have to be tormented any longer!!! Hope this helps!!! Keep your chins up, help is on the way!!!! Keep up the great journeys- wherever you are at in them, it is worth it!!! Dawn in Indy!!!

Aunt Johnie, Don't be surprised if MPlan doesn't come up with another excuse when July hits. I had 2.5 years of a physician's supervised diet and they turned me down because they didn't like the way he kept his notes!?!?! They wanted to to start all over with the same doctor!! I switched insurance companies instead. I know everyone doesn't have that option...but did want to give you a head's up so you'll be prepared for them. Sherri

They better not try anything like that. I have been following all their requirements to a T! I am ready to do this and I hope I don't have to do any appeals or anything like that. You'd think they'd make it easier because it will actually save them money in the long run if you think about the bypass surgeries, insulin, knee replacements, etc... that I MIGHT end up having to have if I don't lose this extra weight. Oh well, I am an eternal optimist so I think everything will work out

Aunt Johnnie, I prefer the optimistic way of looking at things too...but I try to be prepared for the 'just in case' so it doesn't knock all my optimism out of me. I do believe in the adage 'Hope for the best, prepare for the worst'. Be mentally prepared if MPlan does deny you. I had went through the appeal process and for me, it didn't do any good. But that's been 3 years ago. Maybe they've improved since then. I checked a little bit on here on other's experience with them: http://www.obesityhelp.com/morbidobesity/members/list-insurers.php?State=IN&alphaPos=M Forewarned is forearmed many times. Some of these insurance companies will do what they can to make it an uphill battle. It's one that can and should be fought & won. They hope that most will just accept defeat..and many do. Sherri