Question:
Have anyone had the DS procedure with HealthNet

Hi everyone, I want to know if Health Net Ins. put you threw hoops to get approved for surgery. I have health net and want to be prepared if I have to fight.    — TCP1918 B. (posted on March 11, 2002)

March 11, 2002
My husband and I both had the DS with HealthNet with no problems getting approval (his was in June of 2001, mine was in June of 2000). In talking to people currently,however, HealthNet is taking some pretty big strides towards not approving the surgery - claiming that it is now an investigative or experimental procedure and referring people for the RNY instead. I would expect to have a fight on that issue. -Kate-
   — kateseidel

March 11, 2002
I have Health Net of Oregon ~ feel free to read my bio. for more details or email me to see if I can help (if needed). I have gone head to head with them for well over a year now and I've recently "lost" (for lack of better terminology). I even hired a top attorney in the state of Oregon for fighting the exclusion they've put into place and was told that there is a "marissa (?sp?) law" that would take the appeal into a federal case. He stated that nothing is "air tight" as others (obesitylaw.com) has stated for other insurances ~ he just stated that it would cost thousands and thousands of dollars to fight it. He said it still wasn't a sure win. I believe in the future, that insurance companies will be educated enough to learn the benefits of this surgery - not only for the patient but for themselves in preventing other major illness to occur from being morbidly or super obese. I have vowed to fight, scream, yell, voice my opinion in every direction if God allows me to come through this surgery in good health and with more energy. Like I say in my profile ~ they've jacked with the wrong big mouth. :) Good luck in your plight !
   — Lisa J.

March 11, 2002
Hi Tammie ~ I have HealthNet HMO through my employer. I was approved for my RNY within a few hours of when my doctors office called for authorization. I changed doctors and again received almost immediate approval with my new doctor about two months later. Although I do not have any co-morbs, my BMI was just shy of 5O. I really don't even know if HealthNet asked for this info, but I have a history of medically supervised weight loss plans and since my first surgeon required that I see a number of specialists, I had letters from them saying I would be an ideal candidate for this type of surgery. Good Luck to you!
   — PaulaM