waiting on a response from john deer

i have tried to have this surgery for the last two years and i have always had an exclusion on my insurance , i worked so hard to get tenn care, and they told me that it all looked good but i needed six mos of trying to lose weight with a dr. supervising it. and i told her that i went to a weight loss center and i seen a pnp, i was just wondering if that would count. i lost alot of weight with the medication but i always gained it back.

Hi Derrick, I have never understood the insurance's that require the 6 month dr. supervised diet. Most of us have a lifetime of diets behind us that all failed, what makes them think we will succeed with a dr. supervising it? I was just like you in that I was on different diets with and without medication and always lost weight but then would put it right back on plus more! You might want to try calling John Deere and ask for a case manager to be assigned to you, I don't know that this would help but it sure couldn't hurt and maybe they could tell you if there was a way around this or not. It looks to me like you could include your entire diet history including the one where you saw the pnp at the weight loss center and this would suffice but if not, don't give up because that is what they want you to do so they don't have to pay out for the surgery. Appeal and appeal and if that doesn't help then contact an attorney for help. Keep us posted. Greg

Hey Derrick, I have John Deere Select thru my employer and when I made my first call to them, the first thing out of their mouth was "a required six months physician supervised diet". This could not be done by my surgeon. I had to go to my primary care physician and weigh and make sure everything was documented. John Deere faxed me a list of all the requirements that have to be met before they will approve surgery. Thank goodness, I just completed my six months and had my second visit to Dr. Watson on Tues. 11/30/04. I gave him all of my documentation for my upper GI, my psych evaluation, and my medical history which dated back to 1969. Oh yeah, the six month requirement also has to be within three months of the surgery. The surgeon told me yesterday that he will schedule my surgery as soon as he gets the approval from John Deere. We are hoping within two to three weeks. So good luck with all the hoops you have to go thru. I just continued to look ahead for what the future will bring and with blessings and luck on my side, I will be starting the New Year out as a "Loser".

hi Derrick, just keep hounding them, the work you have done before with other Dr's or weight loss clinics should be sufficient. I was told to get 5 years PCP assisted diets. I just went back an pulled 12 years of medical records showing that my Pcp and I discussed diets and tried various meds over that period of time and they finally accepted that. you have to be persistant and patient. if I can be of help dont hesitate to ask. Joe