Hopefully someone can help

I have Aetna and they require a 6 month supervised diet. Has anyone else went through this? Does anyone know exactly they are either trying to prove or disprove by this? I dont want to lose weight and they be like oh well you can do it on your own so we arent approving you and then i dont want to not do it because they may say well it doesnt look like you tried so try it again. Can anyone give me any insight to this? Thanks, Becky

The diet requirements are just another way for the insurance companies to discourage and delay treatment, in the hopes that people will give up and go away, or that they can delay long enough that some other company will end up taking over and footing the bill. There is no medical reason for the diet requirement whatsoever if you can show a history of having attempted unsuccessfully to lose weight. In my case, I had the insurance company try to get out of paying for the surgery by pulling the diet requirement out of the hat when they knew their contract would run out before I could complete the diet and they would have to pay. Since my employer had bought into an exclusion for the next year, I also had no chance of coverage with the new carrier. I fought it all the way to the final appeal, and finally convinced a hearing judge that the diet requirement was not medically necessary, so I am going to get my surgery after waiting a year and a half. But I was very lucky. My reasons were: 1. The diet requirement doesn't meet the standards of the National Institute of Health guidelines, which only state that the patient has failed to lose weight by conservative means, with no specific timeframes. 2. The requirement is arbitrary - some companies have no restriction, some have three months, some six, some twelve, etc., so that there is no medically agreed upon timeframe. 3. The medical literature shows time and again that dieting is not an effective treatment for morbid obesity. 4. The type of program that many companies require is expensive and they don't cover it. My physician estimated the cost of the type of plan (supervised diet, exercise and behavioral) at about $400/month. 5. Many of these plans will deny you if you are successful short-term with the diet, even though studies show that 95% of weight is eventually regained. Anyway, I was lucky to find a judge who listened and agreed with me. So, good luck to you. Most of the time, you can get the six months in before you can get through the appeal process anyway.