HealthNet question - ThinnerTimes

calicowgirl · 03-25-2008, 09:43 AM

I am about to change my Medi-Cal insurance from Kaiser to HealthNet. Anyone have experience with HealthNet- what do they require? I know the 6 month diet thing is pretty much a necessity with most insurances. Anything else I should know about? My ed seminar is May 5th. How long does the process take after that?
BTW- I don't have the 6 month supervised diet yet. Do I have to do that before proceeding to ANYTHING else or can I do it at the same time and schedule the operation for the end of the 6 months?

Thanks for all the help!

annie's mom · 03-25-2008, 09:54 AM

Hi, Don't wait to do your 6 month doctor supervised diet plan.....
And depending on your insurance how you "do" the 6 months could vary.
For instance I had 3 consecutive months of visits to my PCP and need another 3. I was denied 2 weeks ago because I DID NOT have 6 months of Dr. supervised diet history although it didnt need to be consecutive. So
Johns Hopkins Bayview where I am planning to have the surgey advised me to make 3 appts. with my PCP in the next 3 months and have her :

1) document weight and vitals
2) DOCUMENT that weight mgmt. was discussed.
3) Also documented (in my case) that i ma on WW and my loss to date and/or if not doing somethign like WW just have them document what the calorie count diet you are on. (i.e. 1200 calories perday.)

I have also joined WW just to have an ace in the hole if they come back to me ....
That way I will have 3 months of WW and 3 months of doctor supervised weight mgmt.

In short.....hopefully you will have a PCP that supports you in this and document, document, document ...

take care,
Susan

calicowgirl · 03-25-2008, 10:22 AM

Thanks for the help. I just recieved a letter from Dr. Callery's office that I don't have to do the 6 month diet but I have to have proof from my pcp that I HAVE been trying and at some point was on a low calorie, increased excersise diet. She said I also have to prove that I've been overweight for at least 2 years. Seems easy enough. Hopefully she's right! I am going to call my doctor and ask if she's been documenting my weight loss program that we discussed. Thanks again!

KittyKay · 06-21-2008, 11:38 PM

I have Healthnet HMO and didnt have to do the diet. I think Healthnet is the best insurance for wls. Everything for me has gone so fast! I am having a hold up with my EKG due to my PCP. But I would use Healthnet. Any other questions hit me up!

doxielover · 06-22-2008, 09:47 PM

HealthNet isn't requiring the six month diet in California as far as I can tell. I didn't have to do one and neither did 3 other people I've spoken with who are HeathNet members. Make sure and document every diet you've been on for the last ten years and list every way that your weight has affected your life so your PCP can put it in her referral request. Good Luck!