Topic: RE: I am wanting to get in contact with Gary....
My name is Christina and I live in Oregon. I currently have insurance with the Oregon Health Plan. This is insurance for low income people in Oregon. I just found out today that my surgery isnt covered after all. I guess there is an OHP plus plan and a OHP standard plan. The plus plan has the surgery covered but not the standard. In order to be on the plus plan you have to be pregnant, under age 19, blind,deaf and a few other things. I was under the impression I was covered and same with my surgeons office. In the prioritized list off services Weight loss surgery is listed in line 33 as an approved thing out of 608 lines. So it is the 33rd most important thing out of 608 lines. But I guess it states somewhere that only the plus people get it. Although I cannot for the life of me find where it excludes the standard people. When I called the insurance people the lady said yes it is only for plus patients. My question is Is there any way around this??? I of coarse want to submit it but the surgeons office wont see me unless their office visit will be paid for and of coarse it wont be covered but how do i submit the claim if they at least dont see me to try!!! I have no problem fighting for the surgery it isnt fair that some low income people get it and not others. Any suggestions??? Please point me in the right direction if you know where in the heck it is... Is there someone in Oregon that helps with this stuff??? Thanks so much in advance for any help