TOPS

Does anyone know if TOPS is accepted by ins for a 6 month weight loss attempt.

Thanks,
suzy

It counts as far as weight history and if your insurance states proof of weight loss attempts. But if it states "medically supervised diet" I don't think it does cause copies of that has to be sent in your letter of medically necessity letter to the insurance company on a doctor's letterhead/chart documents or script pad. You can call your insurance customer service number and they would be able to tell you. Or call the insurance person at your surgeon's office and they should know.
Good luck,
Connie

Thanks Connie....I have to have a a medical and one from a weigh****chers type thing is all my ins would tell me. I was trying to see if I could do an online version but they will not give me any more info than that. Tried several times. They say they will only get into that part with my dr. I am still trying to get all this started nobody dr wise seems to know how to handle this that I talk to...

Suzy

Are you by chance insured with a UMR policy that is not going to cover WLS as of Jan. 1, 2011? If so you are out of luck cause you do have to have both and they did not give you enough time to do it before your coverage is dropped. Which really sticks!!! Why I ask is that we have had several that have had found themself in that situation.
Otherwise it sounds like you are going to have to do both which is simply making an appointment with your general doctor to be weighed and discuss dieting each month for six months. Make sure you do not miss a month cause you will have to start all over again if you do. Just some of the hoops insurance makes you jump through to hopefully discourage you from making them pay for your surgery. GGGRRRRR
And attending Weigh****chers or TOPS or Jenny Craig or whichever. Make sure you keep a paper trail of that too. Cause it will need to be included in your letter to the insurance company too.
It is worth all this hassel if you still have WLS coverage after the first of the year.
Wishing you patience and luck of course,
Connie

Unfortunantly I think I am as of right now, but I still want to go ahead with the process and have it done. My husband Is going to graduate with his bach degree in the spring and will be getting a job in his field. So I want to have this done in case the new ins would require them as well. The dr weight loss attempt is a sore subject with me...LOL I should have had my surgery this summer. I was doing my medical 6 month session when my dr and his office insited I did not need to be seen every 30 days. I told them and told them I did. Guess who was right. Guess who's weight loss attempt went out the window. I was so upset that I just quit doing anything till now.

Thanks,
Suzy

Suzy I am so sorry you have had such a difficult time trying to get help. Just not fair and I hear these stories so often it makes me crazy!! By the way I work part time for a Bariatric Surgeon if I seem to know more than normal about these issues.
I understand you wanting to get this out of the way now but just so you know each insurance company has their own requirements so you may not need it at all or you may have to have done all this within the last year from when you begin the process. Just keep in mind it may be all for nothing when push comes to shove.
However it all works out please please do not give up cause life on the other side of WLS is so worth all the efforts it takes to get there.
If I can help you with any other questions please feel free to send me a private message or ask here.
Wishing you all the best,
Connie

Thanks Connie, I have not heard for sure if my ins is one or not> My husband works for the Department of Corrections so we r through the states UMR right now. I figure since the word going around is that our ins is not going to be worth anything next year WLS will be cut but have not heard for sure. I am so ready to say I guess I will just be heavy the rest of my life. I have never known anything but being mrobidly obese. At the age of 12 and 13 I was already over 300lbs. My mom took me to the dr at a younger age because of my weight to try and get me help. Back then they  did not do anything. he told her I would grow out of it....Wrong! I was always a super active kid so that was not my problem...I did eat more than I should have but not by a lot. Now here I am over 400 lbs and have a wonderful husband and 5 wonderful boys to raise ages !3, 11, 8, 3, and 2 that I want to stay around for and can't seem to get any help. I have never been able to lose over 90lbs on my own before I start going back up. So disgusted with this whole process.

Guess I just needed to vent a little...sorry.

Suzy

If hubby's new job does not cover it keep in mind that there are companies that you can get a loan with and make payments. The company that seems to be the one most people use is called www.SurgeryLoans.com . And think of it as an investment in your life if nothing else your quality of life. What could be more important to your family than being around to love and raise those children? Ideally you will have coverage but just in case... don't let it be the end to you getting surgery is my point. So many companies are trimming their costs that there are fewer companies that cover WLS than have the exclusion of it. It raises the insurance costs per employee of course so that is why they are trimming it. Just something to think about.
I too have been heavy all my life. And I developed some very serious health issues and the weight just seemed to pile on quickly. Thankfully I finally was able to get my surgery and now I am healthier than I have been in years. Hasn't undone all my health issues but I continue to improve even 3 years out.
Hang in there you will make it happen one way or the other!!