Question:
I will have a new ins. co. in two weeks.

How long should I wait until I approach my PCP with WLS? I have purposely not done this because of 'pre-existing condition clauses.'    — jenn2002 (posted on June 10, 2001)


June 10, 2001
The same thing is happening to me. My new ins. starts on July 1, 2001. This is what I am doing-i hope it helps. I had not been seeing a regular doc, so i found a PCP that is on both plans. I went to see him last week and told him what i wanted. I came in sweats and a really pitiful get up with baseball hat and all. They can help you, it is all up to them whether or not to refer you. I had my detailed three pages of diet history and a formal letter requesting a referral and I even started crying. He felt sooo bad for me, he gave me some free xenical to last for a month and said that it was the ONLY thing i hadn't tried but that surgery sounded like my best option. He said he'd help and that he'd write the referral after the 1st. I told him that I was worried about the whole prexisting thing. he said that if you have been continuously insured by an hmo without a lapse in the past two years that it is unlawful for a doc to use the "preexisting thing" are you insured through your employer or through an independent ins. company? I know that the law applies to group managed providers, I am not sure about independents. He also said that since I had not been to a doctor in the last two years that technically there was no diagnosis made on my obesity. I left the office feeling really good, but really full of self pity, too.
   — Courtney W.

June 10, 2001
In ND If you had a past insurance company or medicaid you should have gotten a certificate of coverage. If you have this and get another insurance within 63 days that new insurance can't count anything you were being treated for as a preexisting condition. I don't know if this is a federal law or what. But if it has been less than that time for you i would ask about it.
   — paula B.




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