Recent Posts
Topic: RE: Peer or group support in Lawrence area.
I would be happy to help you or answer any questions you may have.
Topic: RE: Hello i am new here :)
Or is your insurance one of the ones that will pay for RNY but not the band?
Topic: RE: Exclusions in Kansas! Contact your Representatives!
Mike, I understand what you are saying. But the thing with the exclusions at least for my plan, because I am state employee is at the state level. I have spoke with BCBS of KS and they told me that they were not the ones that wrote the exclusion into the current contract, but the state has put the exclusion into our coverage. Many times this is the case, because the insurance providers at least in this case aren't the villain and seem to understand now that WLS actually cuts costs over the long haul. And most employers who have BCBS of KS may be in the same situation I am, not because of the carrier but because their employer doesn't understand the lifetime savings potential.
Exclusion for this proven lifesaving tool is discriminatory for those of us who are morbidly obese. Denying coverage by mandating an exclusion is certainly not an option either. If I were to go with mandating an exclusion or mandating coverage, I would certainly go with the latter.
Sorry, while I understand on one hand. On the other I don't think a mandate on this issue wouldn't be such a bad idea, since overall the cost of treatment for an obese patient overtime is higher than the treatment of someone who undergoes this sugery. I think even mandating coverage for those that meet certain criteria, rather than a blanket mandate would be an option too.
But what do I know. Maybe I'm wrong. :) All I know is that the only way I will have this surgery is if my insurance will pay for it. And I don't think I should have to look for a job who has insurance who covers this surgery, just because my health plan doesn't, especially when I have a decent job that I like and prefer staying at.
Chad
Topic: Attention ALL LAP BAND Buds
Please join us at a new nation wide forum JUST for LAP BAND ers! We have named it Band Buds..It was created by several members here at OH..we really hope you come! You will LOVE it!
http://z7.invisionfree.com/Band_Buds/index.php?act=idx
Just click the link to register..we will be watching for you!
Topic: RE: Hello i am new here :)
I had gastric by-pass and my insurance through United Health Care. I know that many of the larger employers in Topeka offer UHC. I was only out the cost of a hospital stay which under my plan is only $500 out of pocket for me. My insurance covers the rest... pretty good plan
Topic: RE: Exclusions in Kansas! Contact your Representatives!
Chad,
No one likes exclusions in insurance policies, but no one likes mandates either. FYI, mandates such as you are suggesting will increase the cost of health care. Currently roughly 20% of the cost of health insurance in small group coverage are a result of federal and state mandated coverage.
Our fight for the right to have WLS coverage is not with the States, its is with the carriers. We have to prove that having the surgery is cheaper for them in the long run than not having it. You see, it has to be cost effective for the carriers to provide coverage for it. The only way that can be done is with a set guide lines as to how you qualify for the surgery and provin outcomes. This will take information from the providers.
What needs to be done is to establish a task force to collect the needed information and get the facts out to those who can effect the change.
This is my opinion, I could be wrong.
Life is a journey, don't waste the trip.
Mike Wise
300.6/188.2/178
RNY/11/08/05
Topic: RE: 19th.... anyone around
Hi Too bad I have a standing Tuesday night thing...I'd love to come meet you and pick your brains...my surgery is scheduled for July 31. The airport is just sort of way out there all by itself and there's not much to do close, especially if you don't have a car handy. I hope you find someone! Robin
Topic: 19th.... anyone around
I am delivering my 12 yo to her dads at the MCI airport on the 19th.
Anyone want to meet for dinner or just a little get together??? Dont really want to eat alone in my hotel room...
Talk to me!!
Karen
Karen
260/164/150
May 13,2005
Topic: RE: Hello i am new here :)
Hi,
I just went and meet with my surgeon Dr. Hamilton on Tuesday June 12th. My insurance is BCBS Anthem through Goodyear, they do cover both types of surgery. I am just in the beginning, I have to go and meet with a psychologist next week and do a sleep study, then we will see what other hoops the insurance company will throw my way.
Dr. Hamilton told me that Medicare or Medicaid ( I get those two confused) but they have approved the surgery and he said anytime that they approve something other big insurance company normally follow. So your insurance might reconsider. I take it you work for BCBS, I know that at the seminar I went to they said BCBS State does not pay but hopefully they will change their mind.
Good luck in your journey.