Question:
Please Help - Ins. Question
Please Help!!! I live in Texas and want the DS procedure done. No doctors in Texas do this procedure. My Insurance - United Healthcare Choice Plus - only covers morbid obesity if I use an in network doctor. But their are no in network doctors in Texas. Any ideas??? — Melissa T. (posted on September 25, 2001)
September 25, 2001
If you would consider having it done outside of Texas, I know my insurance
covers a wide span area for PPO, not just within my state. I don't know
how yours works, but maybe this would be another option. Good luck!
— Tisha G.
September 25, 2001
Are you sure? I live in Houston, and I can't imagine no one doing that
surgery. But if it's true and you really want WLS maybe you would consider
another type RNY?
Good Luck
— Cindee A.
September 25, 2001
Check with your insurance about an "inadequate coverage" clause.
With my insurance, (Aetna), if there is no Doctor in my network for a
certain procedure...they have to let me see a Dr of my choice in my area
due to the fact that they have not provided adequate coverage in that
field. Hope this helps.
— skymaxjr
September 26, 2001
melissa, where do you live in Texas? I live in Austin... in Temple (about 1
hour away)
there is Dr. Symmonds (Scot and White Hospital) and there is one (2 hours
away) in San Antonio
I believe his name is Dr. Pritcher? Good Luck!
— rinkadinktx
September 26, 2001
I know how you feel... I'm in Florida and I want the DS. I am getting my
papers ready to send to Dr. Rabkim's office because he's who I want to do
the procedure. I have Cigna International so I have a good selection of
doctors in the world, but Rabkim is unfortunately not one of them. All I
can do is have the doctor submit a request and see if insurance approves
it... and if they say no, I'll argue until I get my way ;) Good luck to
you :)
— [Anonymous]
September 26, 2001
The doctor I chose to do my surgery (10/17/01) is out of network. So at
first my insurance company said that they would cover at 50%. I called my
insurance company with another type of question and a very kind lady there
told me that she was concerned for the out of pocket expense to me. I
explained to her that there was no in network doctors who did this surgery.
She had me go to the provider web site, print out the surgeons in a 20
mile radius from my zip code, call these doctors and note if they covered
this or not. Well none of them did. I faxed the list with a letter of
explaination. I got a call two days later to say that the out of network
was overturned to in network.
If you are willing to come to California, I would like to recommend Dr.
Keshishian in Delano, Ca. 616-725-4847.
He does not require a lump sum of money down before your surgery. His
program fee is $2000 vs Rabkins $3000. Good Luck.
— Jackie E.
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