Question:
Health insurance may change 1/1/03 - my surgery is scheduled for 1/2/03... !!!
My employer will most likely be changing our health insurance effective January 1, 2003. My surgery is scheduled for Janaury 2, 2003. They told me they will inform me as soon as they make their "final" decision abotu which insurance we will have. I already called my surgeon's office twice (and emailed her P.A, too) to seeif I could be moved up. They are not willing to do it. Does anyone know what my rights are? I know PA has a Continuity of Care law, but I am not sure if it would apply to this situation. Also, my DH has Health America insurance, which I can enroll for, but I am waiting for a copy of the contract to see if WLS is definitely covered. HELP! — oneL (posted on October 24, 2002)
October 24, 2002
I faced a similar situation last year and the surgeon I was using wasn't
willing to work with me at all. I notified them October 15 that we would
probably change insurance December 1 and they said tough. So, I found
another surgeon. I had my first consultation on October 30 and had surgery
November 29. I know that I was very fortunate to find a surgeon (and a
very excellent one) who could take me that quickly. But i had my surgery
and both insurance companies ended up paying. The first paid for the
surgery and the day after and the new one had to pay for the remaining
three days.
Good luck.
Open RNY - 11/29/01 -151+ pounds
— Patty_Butler
October 24, 2002
I wouldn't take the chance you new insurance may have an exclusionary
policy against WLS. Research surgeons in your area and call and explain
whats going on and see if they can get you in.
— Candace F.
October 24, 2002
can you get your date moved up? I had extenuating circumstances, and got
mine moved up by nine weeks!
— Debby M.
October 24, 2002
I tried to move my date, but they say they can't do it. I called the
receptionist twice and emailed her P.A. ..... not happening. Kind of makes
me mad.
— oneL
October 24, 2002
My surgeon is kinda far from you but they move fast!!! Dr.Lisa Bellin; pa.
hospital she works with dr. kirkland
there# is 2158293697 it'll take a week for a consult and a month later if
approved you'll have surgery check out my profile and my angel's maynita
vaughn-wimbush i told her about my surgeon and she was approved and
scheduled in about a month her bate is 12/15!!
— Dia C.
October 25, 2002
as long as you get your pre approval you should be okay even if your
insurance changes there is something known as a pre exsisitng clause or
something like that not sure excally what it is called call the insurance
commisioner in your state and they can give you specific advise, from what
i know of the law i am thinking of as long as you are approved for a
certain procedure and then your employer changes policies then the new
insurance has to pay for the procedure you were previously approved for, of
course if there is a exclusion you may run into a problem, check it out
with the insurance commission in your state to be 100 percent sure, hope
this helps, and congrats!
— T C.
October 25, 2002
The last poster is incorrect. Your approval for surgery is only good for
the insurance co that gave the it. If you change insurance companies you
will have to be approved all over again and the pre-existing clause means
that they may not cover any pre existing conditions for a certain amount of
time usually 6 months, but if there is not a laps in coverage you should be
ok, it all depends on the contract your employer selects. It would be to
your advantage to speak to you employer about your concerns. Hope this
helps.
— jerzeygirl71
October 25, 2002
Sweetheart--I would not fool around at this point with an approval in hand.
I would tap into my "rainy day fund" and COBRA this insurance
until I was free and clear of the surgery.
— Wannabe A.
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