PREFERRED CARE INSURANCE???????

I WAS SCHEDULED TO HAVE MY WEIGHT LOSS SEMINAR TODAY AT 1PM AND RECEIVED A CANCELATION 2 DAYS BEFORE SAYING THAT NOW.....MY INSURANCE COMPANY IS REQUIRING THEIR PATIENTS TO GO THROUGH A MULTIDISCIPLINARY WEIGHT LOSS PROGRAM. LIKE THE ONE AT STRONG CALLED ONE TO ONE/CORE...NO ONE AT MY INSURANCE COMPANY OR ANY OF MY DOCTORS TOLD ME ABOUT THIS BACK IN JANUARY WHEN I STARTED THIS PROCESS.I AM SOOOO UPSET RIGHT NOW.. I ALREADY HAD MY APPOINTMENTS TO NUTRITION AND PSCHIATRY BUT DR. O'MALLYS OFFICE CANCELLED THEM BECAUSE OF MY INSURANCE SAYING THEY CAN NOT HELP ME ANY FURTHER UNTILL I COMPLETE THIS PROGRAM.. BUT NOW MY INSURANCE COMPANY HAS ME UNDER REVIEW TO SEE IF IT IS MEDICALLY NECESSARY FOR ME TO DO THE WEIGHT LOSS PROGRAM..LET ALONE HAVE THE SURGERY..I JUST CAN'T BELIEVE THE RUN AROUND AND PASSING THE BUCK THAT GOES ON BETWEEN ALL THESE PEOPLE.. MY QUESTION IS....HAS ANYONE ELSE HAD THIS PROBLEM WITH PREFERRED CARE?? AND IF SO...WHAT DID YOU DO ABOUT IT??I AM 125-130 LBS OVERWEIGHT AND HAVE A BMI OF 46-47...I FINALLY FELT LIKE I WAS TAKING CONTROLL OVER MY WIEGHT AND NOW I RUN INTO THIS.... WHY WASN'T I TOLD THIS 8 MONTHES AGO?? SORRY TO VENT SO MUCH...I AM JUST SO MAD......

Gen, I feel so bad for you, yet this doesn't give me a warm fuzzy feeling. I have PC also and I have a tentative surgery date of late October. My paperwork will be sent to PC the end of August for approval. I to, found out about the new requirements from PC back in mid May. I phoned my contact at PC back in late March to get all the requirements for WLS. Nothing was mentioned about this new program. I found out by going to another surgeon (Dr. Boss) and his secretary informed me of this new requirement and would not even allow me to attend his seminar. I got the clarification from PC that they changed this effective some time in April. I questioned what to do....they informed me to have my PCP write a letter of medical necessity, which we did and PC asked who the surgeon was and requested paperwork from him. Dr. Galvin's office did not send in what was requested. Instead they pushed my file to surgery scheduling and the inquiry was closed at PC cause there was no response from my surgeon. Finally given a date and just waiting for approval. This is such a long, emotional process that we go through. I have to pay a large deductable that I have my fingers crossed that I have it this year, cause I am not paying all this next year. If I don't have the surgery then next year, I will be changing insurance! Keep on trying and let me know (e-mail me) how it's going. Lucy C

Hello Gen My name is Tammy and I am in Wayland, I too have PC as insurance. I had everything done ready to submit for final approval and BAM. Instead denial. As of 1 April PC (Preferred Care) has a mid year policy change for any WLS.(Which a manager there stated to me its a Federal change, not them, b/s) We must now complete a 30 week program, One To One is the only one at this time that is approved by PC. PC will cover half of the cost ($700), and every visit is treated as a specialist appointment. Now with that said I have been so upset for the past 3 weeks. I called PC many times over the last 4 months about any policy change and they out in out lyed to me. They went as far as telling me that Highland knew about this back in February and they are the ones responsible for our denial. I am going to appeal the denial. PC had 3 different departments calling me telling I should appeal my denial. BUT the Dr office will not help me with this, . If you would like to call me I can tell you how I got PC to pay 100% of the cost to one to one. Email mail me if you would like. Thin wishes and WLS dreams Tammy