Question:
Insurance company says to go to a doctor out of network.

I need a medically necessay reason does anyone have a good reason they said that me just preferring to a doctor outside of my network isn't a good enough reason.    — fabulouspre (posted on July 26, 2007)

July 26, 2007
I was in perferct health except my 278 lb when I had my surgery. I got approved because I have a family history of high blood pressure and heart attacks, I was trying to prevent this problems.
   — rollergirl41

July 26, 2007
It's interesting that your insurance company would tell you that. Do you have an in-network primary care physician? If so, I suggest work through him/her and through the surgeon in-network to get you approved. The surgeons know how to write up these things --or at least they should. That is the most craziest thing I've ever heard. Also check with the state insurance laws to see if they have any laws regarding mandatory coverage of WLS.
   — the7thdean

July 26, 2007
Ditto the above but like NaDine said work with your primary and if the referral is to someone who specializes in whatever then double check that no one in the so called network deals with the issue and that should be your in for approval.
   — 1968 Loser

July 30, 2007
Our insurance has different options. Knowing we used some out-of-network doctors, we pay a bit more to have that option.
   — Novashannon

August 3, 2007
Why do you want to go out of network for the procedure? I can't think of any valid reasons unless maybe the in-network doctor is incompetent or something like that... but I think you may just be stuck on this one. Either go in network or pay to go out of. Best wishes, Sid
   — mrsidknee