kind of new here

Hi, My name is Victoria and I live outside of Philly. I am going to HUP to see  Dr Williams for Lap RYN. My consult appointment with him is April 11.  I was all set for surgery nearly 2 years ago but Aetna decided to make bariatric surgerya seperate thing a company had to buy into and my Hubbies company did not do that.  My surgery was scheduled after the change so it was a no go. This was devistating for me and it took a long time to get over it.  In hind sight it was a great thing that happened. We got pregnant with our third child shortly after he is such a sweet little boy. This gave me a lot of time to look into myself. For the first time I can remember I truely love my self. I just don't love my weight and how it makes me feel. I love myself enough to jump on this crazy ride again,but with different insurance. I am about 200 Lbs over weight and ready to get rid of it I no longer need it as a shield between me and others in my life. As you can tell I did a lot of inner research on myself. I appreciate you stories and help you are all an insparation. If anyone has used Medicare as there insurance can you please let me know how it was. I am affraid of the insurance at the moment more then anything else. All my best Victoria

Hi, Victoria: Welcome!  I lived in Philly years ago (Center City).  How far outside Philly are you? I'm disabled and on Medicare.  My Medicare is through an HMO, though.  Do you have straight Medicare or is it an HMO or a Medicare Advantage plan (Aetna, Blue Cross, etc.)? I was lucky that I qualified for Medicare when I did.  I had been paying obscene amounts of money every month for an individual plan through my HMO, and they changed the individual plans so that the WLS patient had to pay 30% of the surgery costs.  With my HMO Medicare, I only paid my hospital copay and a smal copay to the surgeon. Medicare covers WLS.  Straight Medicare doesn't require preauthorization, but you have to find a surgeon and hospital that belong to a WLS Center of Excellence.  If you have a Medicare Advantage Plan or Medicare HMO, the hoops you have to jump through to get WLS differ according to the plan. I had to get an attorney to get my HMO to approve me for WLS, but that had nothing to do with Medicare because I was still on my individual coverage then.  My HMO said WLS wasn't medically necessary because I was too fat.  (Yep, can you believe it?)  I fought 'em and won. Holler if you have any more questions. Kix

Thank you, I have flat medicare. Yeah you don't want to be to fat for WLS! I was told by a therapist I was too healthy for WLS. I said I am 200 Lbs over weight how healthy am I. It takes me 35 Minutes to get into the city. Hup is a WLS of excellence. I hope to be on my way soon. Talk to you soon Victoria

HEY VICTORIA,         WELCOME ABOARD!! THAT INSURANCE CRAP CAN SURE MAKE YA CRAZY I KNOW. MY COMPANY TOOK THERE SWEET TIME GIVING ME AN ANSWER. BUT SURE DIDNT STOP ME FROM CALLING THEM AND DRIVING THEM ALSO CRAZY LOL... PATIENCE WAS NEVER A GIFT TO ME LOL....

HUGS MARGE

Thank you so much. All this insurance stuff has taught me patience it was a lesson I needed to learn.