Getting the ball rolling...how soon is too soon?

StacyB88888
on 6/24/11 5:55 am - FL
Ok so I am applying for jobs where I know they cover WLS and DS....I lived and worked in MA previously so this pre-existing condition limitation is a relatively new concept to me...since  all of my jobs in the past offered day 1 benefits with no exclusions on pre-existing and my husband's previous employer self insured and despite their flaws really stepped up to the plate when it came to covering whatever, whenever unless it was WLS..which I guess is good a twisted way since I remember calling about the lapband and whether they would cover it. in

So assuming I am hired...how soon do I start laying the groundwork to have DS surgery? I know that I would need to put in a year in order to have the FMLA cover my recovery time....but can I start consults/pre-op testing before the one year mark?

Also records of my weight are going to be hard to find since I discovered the convenience/cost effectiveness of walk in clinics ....since I have been avoiding the doctor unless absolutely necessary. How far back can I go? Also I know that the health insurance companies can tap into a medical database when selling private insurance. Humana questioned me about every single sinus infection( going back 10 years covered under other insurers),UTI, headache before telling me I was too fat to insure) Why can't these companies tap into that resource to see our weight history? If I weighed 275 in 2001, 375 in 2005 and I weigh in the 340's now(thank goodness they don't have record of the pre gluten free 450's)...isn't that enough proof that I don't have a handle on a healthy weight...even if I lost it and regained it in that time frame would it really matter of there was a tool out there that could control it?

Yes I am thinking waiting 1 year is going to be bad enough...having to wait 2 to prove that I am 'fat' is ridiculous considering my long term history....the only time I have maintained a normal weight was between 1992 and 1996.

Lol...my post for advice turned into a rant..sorry. Thanks in advance!


no_more_rolls
on 6/24/11 6:16 am - Jackson, MI
Every insurance company and surgeon's office is going to be different.  I suggest researching DS surgeons.  Find out who is close to you or who is worth traveling to see.  Also you need to find out what insurances they accept.  Just because you have insurance that covers the DS, does not mean it will cover the surgeon you select.  Perhaps the insurance coordinator at the surgeon's office you select may be of some help.  Many surgeon's offices require you to attend a free seminar before they will even schedule you an appointment...and that could take over a month.

The good news is, so I've heard, is that insurance companies are no longer to exclude based on pre-existing health issues....something to do with the national health plan and changes made when the bill was signed.

I hope that helps!
Winning isn't everything, but wanting to win is.  
DONT BE AFRAID TO FAIL......BE AFRAID NOT TO TRY! 
highest weight 313/ surgery 255 / current 185 / goal 135  Height 5'6"
       
KarenFlorida
on 6/24/11 7:51 am - Orlando, FL
I think you can get a PCP and start going right away, and have them document that you are making efforts to lose weight. A lot of policies want you to have 6 months of medically supervised dieting before approving WLS. As for length of time being obese, do you think you can get copies of any old records from the places you've gone for care, where they documented your weight? If you can remembe any of the places, they can probably pull your old records from a few years ago. Good luck!

Karen
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