ladies!!experience with harvard pilgrim anyone?

i am getting married in may,and i will then have harvard pilgrim/health care inc. have any of you had dealings with them?my medicare at least for now will pay for me to start the program until his insurance kicks in(and there is no waiting period!!yipiieee)

Hi Jennifer, I too have Harvard Pilgrim Healthcare. I just got them this year. They are very easy to get approval with, you just need a failed doctor supervised diet. They do not require you to lose weight prior to your surgery. I have talked to them on the phone several times and they were very helpful and courteous. I will be going to Brigham & Womens Hospital in Boston for lapband surgery. I already have approval and pre-cert done even though they are out of state for me but in their network. I have had many people tell me they are so easy to get approval with as they see the benefit to having WLS. Hope this helps you out! Valerie

valerie,ty for the reply....what is considered a "failed attempt?i have done lots of things(of course with the insurance i have now so they wont have documentation of this)zenical,phen-phen(which gave me heart damage)i worked with an obesity clinic a couple of years ago,curves,meridia,dieticians,and a few others,but would i need the documentation?are those considered attempts?

Hi Jen, You must go to your PCP once a month to be weighed, etc. My doctor has also sent me to a nutritionist whom I also meet with once a month. Your doctor will probably put you on a 1,200 calorie diet and ask you to do some type of exercise. The key here is to have your doctor put all of this info in his/her notes for each visit. Most companies want at least six mos. doctor supervised diet. When I talked to Harvard recently, I forgot to ask the length of the diet.This documentation is very, very important. You don't have to necessarily lose weight under the doctor supervised diet, you just have to show the attempt for the insurance company. The documentation from the other things you tried would also be helpful. The more the better. Try to get copies of everything you have done or participated in to lose weight. I hope this helps you out. Valerie

Hi, mine was pretty easy too. I went to Dr. Drinkwater in Nashua (who is unfortunatly no longer there). I never delt with Harvard at all, the program coordinator did it all, I never even got a refferal. I went to an orientation meeting, then set up my 1st appointment, filled out all the Dr's paperwork with history (diets, etc) I included copies of all my Weigh****ers cards (for some odd reason I had saved them all from the many times i tried weigh****chers). From there I started the program, saw the dietician and all of that. Once I lost the weight the DR required, my Dr gave me a date and submitted me for final approval, which I got really fast. I never made a single call to harvard, but I did write a letter outlining all of my past efforts etc to be sent with my stuff for approval. Hope this helps you!

I have Harvard Pilgrim and they are great. It only took a couple of hours for me to get approved. I didn't have to do any type of supervised diet. I did have Cigna and oh my..they were terrible. But yes, HP is very good.