I apologize if I sound irritated but I just got off the phone with the most clueless insurance rep EVER. I called to see if my plan covered seeing a nutritionist or RD and the lady was like, "well it covers, this, this and this for diabetes but nothing for weightloss." So I'm like ok, so am I listed as a diabetic, because I recently received this package in the mail from Anthem and it was all about diabetes management?? But I haven't been diagnosed with diabetes just PCOS. "SO then she is like well I don't know what PCOS is, but if you were diagnosed with diabetes then you can see a nutritionist." That was the end of our very productive phone call.
Has anyone had any luck dealing with insurance providers and getting services for PCOS??? I don't really see my need to visit a nutritionist simply as a weightloss issue because I have specific dietary needs having been diagnosed with PCOS. I feel like more education is necessary for me to be able to manage the PCOS better, similar to a diabetic receiving education after a diagnosis. Am I wrong here?
Any tips/thoughts would be greatly appreciated!
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I'm sorry I don't have any advice on your situation. But I am just as frustrated with my insurance policy. I don't understand how they operate. But good luck to you!
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Maybe if your doctor refers you? I can pretty much do whatever I want on my plan, so it's hard to say. Does your company have a website? That might be more productive.
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Is it really a service that you need your insurance company to pay for, or can you get a few books nutrition and pcos, and then go over some key items with your primary care doctor?
Keep in mind that the more 'pcos-related' care items that go on your record, the more trouble you're likely to have later on if you have to switch health insurance companies and go through the application process.
Do you have high cholesterol, or anything? Does your insurance company offer nutritional counseling for that? (high cholesterol is actually being considered by some to be more critical to people with diabetes than watching carbs...be sure to read that NYTimes article I posted last week.)
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I think Kat makes a good point about being able to do this yourself. Years ago I went out of network to see a dietician that was an expert in PCOS. Cost me a fortune, but I kinda had to do it to shut my doctor up (he thought this woman could solve everything). She cost $300 and the IR Diet book costs about $14, and there was absolutely no difference between the advice at all, it was the same plan. I had no problem with her services, she knew her stuff, but for me, it was a waste of money. Also, since many doctors don't know anything about PCOS, I doubt most nutritionists do either. She might even give you a diet plan that is actually bad for PCOS. IMO, try the book first.
I have aetna insurance and I just went to a reproductive endo. that I had a referal for. He ordered lab work done to check my hormones for pcos and my insurance didn't cover any of it because they said that they are maternity test. they cost over $1000. I'm very upset. I also don't know yet if they are covering the doctors visit or the ultra sound they did at the office. I'm like what is the point of having insurance if they don't cover anything. The doc. wants me to come back and she the nutritionist too. I'm sure they won't cover that either.
I have no advice for you...just irritates me even more when someone talks to a clueless rep. Back in Dec. I was told my insurance had to have 'prior approval' before they could fill an RX my doc gave me (non-pcos related).
When they start employing people who KNOW what medical conditions/diseases are then they can start having a say in what my meds my doctor thinks I need.
I absolutely understand your frustration. This is completely off topic - bt a few years ago, my mom had a stroke. They did emergency brain surgery - a few months later, my daddy got the bill. He called the insurance and they said they wouldnt pay it because he didnt get a second opinion before they did surgery. Needless to say, daddy won that battle and the insurance eventually covered it. But can you imagine the nerve?
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dealing with insurance companies 
