medically supervised diet

Valicia
on 8/31/07 5:41 am
My new insurance through my work will cover my RNY.  It does not go in effect until January, 2008. Can I start my required 3 month medically supervised diet now, under my current insuranse - which is different than it will be in January.  Will the company in  January (Fiserv) accept it if I start it prior to their insurance coverage?  I want to get started! Thanks, Val
hopefulnickster
on 8/31/07 7:36 am - Peoria, AZ
IT definitely doesn't hurt to try to know? What's the worse they can say? NO? Well, if that happens then all you have to do is keep doing what you were doing already. BUT, I have yet to read an insurance policy that says you have to be on a 6 month diet history while on this insurance program.
Kahlua
on 9/3/07 2:56 am - NJ
Dear Val, I have never heard of any insurance company denying b/c they didn't pay for your office visits. In fact, several plans will accept the 6 month med supervised diet from anytime in the last few years. All they need is your med records stating you are being supervised by your PCP, even if that PCP isn't in network with your new insurance. HOWEVER, one word of caution-- actually 3 words: PRE EXISTING CONDITION. You need to find out if your NEW insurance (Jan) has any pre-existing clause and ask for the details specifically (have them send it to you in writing). Sometimes, the plan will allow for coverage of a condition as long as you haven't been treated for it in the last 6 months or year. Othertimes you have to wait 30 days, 60 days, 90 days, whatever the plan states, for treatment of a condition which you were recently treated for under the old insurance. If your new plan has this P.E.C. clause and you can't get a satisfactory info about the details from ins, ask your Human Resources rep for a thorough explaination of the"pre-existing condistion" regulations for this new plan, and ask if there are any diagnoses/treatments for which this P.E.C. applies/doesn't apply-- sometimes it's only for specific illnesses. Therefore, if you have the P.E.C. clause for obesity treatment, you may not want to start the diet. BUT all you need is your doc to express concern about weight, and recommend lifestyle changes, and weigh you monthly. That's not really recieving "treatment" just monitoring. You may also want to ask what constitutes "treatment" with this ins comp. Ask if a PCP office visits is considered treatment. Good luck, Kahlua
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