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Topic: Surgery is scheduled
I got the call today that my surgery is scheduled for Feb 14th. Yep thats Valentines Day. This is be the best Valentines day ever for me!!!!
Topic: RE: Employer Changed Insurance ughhh
I am so sorry! Best wishes on finding an alernative for payment! : (
JillinWarren
on 12/8/10 3:53 am - Warren, NJ
on 12/8/10 3:53 am - Warren, NJ
Topic: RE: Insurance Denied by Dr Bertha with 2 weeks to surgery date
Dear BubbleButt,
While of course we all do something that will support us, that is not usually enough, especially not for anyone in a professional career. Most of us find a higher purpose in our jobs that meets our standards for ethical, moral, etc. behavior. Doctors are required by their profession to go beyond doing anything for the money. Haven'y you ever heard of the Hippocratic oath?
While of course we all do something that will support us, that is not usually enough, especially not for anyone in a professional career. Most of us find a higher purpose in our jobs that meets our standards for ethical, moral, etc. behavior. Doctors are required by their profession to go beyond doing anything for the money. Haven'y you ever heard of the Hippocratic oath?
Topic: RE: Employer Changed Insurance ughhh
Sadly, getting your own ins would not help. Private policies do not cover WLS for the very reason you need it. People would get a private policy long enough to have WLS and then drop the policy. No ins co could afford that.
Welcome to the world of self pay. :o(
On December 7, 2010 at 12:18 AM Pacific Time, nikkib_07 wrote:
I am so upset right now. The hospital I work at used to have Cigna and now they changed it to Aetna and they didnt add weight loss surgery to the insurance so now if I wanted to get weight loss surgery i would have to either get my own insurance or do self pay. I am so mad. I just had to vent yall sorry.Sadly, getting your own ins would not help. Private policies do not cover WLS for the very reason you need it. People would get a private policy long enough to have WLS and then drop the policy. No ins co could afford that.
Welcome to the world of self pay. :o(
Previously Midwesterngirl
The band got me to goal, the sleeve will keep me there.
See my blog for newbies: http://wasabubblebutt.blogspot.com/
The band got me to goal, the sleeve will keep me there.
See my blog for newbies: http://wasabubblebutt.blogspot.com/
Topic: RE: 6 month diet/gained weight!?
Good luck to all!
Jennie
It is usually the doctors that require actual weight loss, not the ins co's. Not all the time. just usually.
On December 7, 2010 at 10:10 PM Pacific Time, HarleysValentine wrote:
Just wanted to follow up and answer my own question...YEP they approved me! My RNY is scheduled for Jan 17. Approved on the first try. Apparently they looked at my overall not just a one month gain (you know how paranoid you get with this experience!) Good luck to all!
Jennie
It is usually the doctors that require actual weight loss, not the ins co's. Not all the time. just usually.
Previously Midwesterngirl
The band got me to goal, the sleeve will keep me there.
See my blog for newbies: http://wasabubblebutt.blogspot.com/
The band got me to goal, the sleeve will keep me there.
See my blog for newbies: http://wasabubblebutt.blogspot.com/
Topic: RE: 6 month diet/gained weight!?
Just wanted to follow up and answer my own question...YEP they approved me! My RNY is scheduled for Jan 17. Approved on the first try. Apparently they looked at my overall not just a one month gain (you know how paranoid you get with this experience!)
Good luck to all!
Jennie
Good luck to all!
Jennie
Topic: Employer Changed Insurance ughhh
I am so upset right now. The hospital I work at used to have Cigna and now they changed it to Aetna and they didnt add weight loss surgery to the insurance so now if I wanted to get weight loss surgery i would have to either get my own insurance or do self pay. I am so mad. I just had to vent yall sorry.
Nekeya B.
Topic: RE: Can't get insurance after wls?
I may have to opt for a "real" job, just to get insurance (hubby is self-employed, thus the insurance issue!)
Can I just say that the insurance industry sucks balls? There, said it anyway. It doesn't matter that we've paid thousands and thousands of dollars with few claims, since we're all basically healthy. Our premium for family coverage is over $1000/mo. with high deductibles, and we can't switch to new insurance because a) Two family members are obese; and b) I had surgery to *not* be obese.
Tami
Maybe not. I believe starting 1/1/11 each state has to come up with high risk ins for people like us and it's supposed to be affordable. Likely it won't cover much but it's better than nothing. I know absolutely nothing about this but there is a lady asking about it on the insurance board. She is looking to see if her state ins (not medicaid) will cover WLS. She might have more info for you.
On December 6, 2010 at 4:00 PM Pacific Time, TamiFromAL wrote:
Well, on the "plus" side, it looks like it's going to be just as difficult for my son and hubby, since they are both obese :-( I may have to opt for a "real" job, just to get insurance (hubby is self-employed, thus the insurance issue!)
Can I just say that the insurance industry sucks balls? There, said it anyway. It doesn't matter that we've paid thousands and thousands of dollars with few claims, since we're all basically healthy. Our premium for family coverage is over $1000/mo. with high deductibles, and we can't switch to new insurance because a) Two family members are obese; and b) I had surgery to *not* be obese.
Tami
Maybe not. I believe starting 1/1/11 each state has to come up with high risk ins for people like us and it's supposed to be affordable. Likely it won't cover much but it's better than nothing. I know absolutely nothing about this but there is a lady asking about it on the insurance board. She is looking to see if her state ins (not medicaid) will cover WLS. She might have more info for you.
Previously Midwesterngirl
The band got me to goal, the sleeve will keep me there.
See my blog for newbies: http://wasabubblebutt.blogspot.com/
The band got me to goal, the sleeve will keep me there.
See my blog for newbies: http://wasabubblebutt.blogspot.com/
Topic: RE: Can't get insurance after wls?
Well, on the "plus" side, it looks like it's going to be just as difficult for my son and hubby, since they are both obese :-(
I may have to opt for a "real" job, just to get insurance (hubby is self-employed, thus the insurance issue!)
Can I just say that the insurance industry sucks balls? There, said it anyway. It doesn't matter that we've paid thousands and thousands of dollars with few claims, since we're all basically healthy. Our premium for family coverage is over $1000/mo. with high deductibles, and we can't switch to new insurance because a) Two family members are obese; and b) I had surgery to *not* be obese.
Tami
I may have to opt for a "real" job, just to get insurance (hubby is self-employed, thus the insurance issue!)
Can I just say that the insurance industry sucks balls? There, said it anyway. It doesn't matter that we've paid thousands and thousands of dollars with few claims, since we're all basically healthy. Our premium for family coverage is over $1000/mo. with high deductibles, and we can't switch to new insurance because a) Two family members are obese; and b) I had surgery to *not* be obese.
Tami
Topic: RE: My Empoyer's Plan vs my stoma
Has anyone had any experience appealing for an exception/waiver to the Empoyer's Plan???
A lot of ins co's are going to the one WLS in a lifetime and honestly, I can't blame them. Look at the band board, you can often see someone basically explaining that they know the band has horrible results, awful stats, and lots of complications but they will get it anyway and just revise if it doesn't work. I wouldn't want to pay for additional surgeries for someone like that either. I think it is that population (those that knowingly get procedures they know are not likely to work) that caused ins co's to adopt the one WLS in a lifetime rule.
Sadly they have every right not to cover a revision. Putting a band over your bypass is not a correction to the stoma, it is a band over your bypass. Correcting the stoma, unfortunately, would be something like Stomaphyx that does not work either.
Also, if you end up self pay I certainly wouldn't get a band over your bypass, it's quite unlikely to work.
On November 29, 2010 at 6:31 AM Pacific Time, Jayne wrote:
My employer's healthcare plan specifically states one bariatric procedure per lifetime. However, my surgeon has stated that I require a Band Over Bypass to correct a dilated stoma (staples came out of place ).... The insurance rules this BOB a second bariatric procedure not a correction to the RNY....Has anyone had any experience appealing for an exception/waiver to the Empoyer's Plan???
A lot of ins co's are going to the one WLS in a lifetime and honestly, I can't blame them. Look at the band board, you can often see someone basically explaining that they know the band has horrible results, awful stats, and lots of complications but they will get it anyway and just revise if it doesn't work. I wouldn't want to pay for additional surgeries for someone like that either. I think it is that population (those that knowingly get procedures they know are not likely to work) that caused ins co's to adopt the one WLS in a lifetime rule.
Sadly they have every right not to cover a revision. Putting a band over your bypass is not a correction to the stoma, it is a band over your bypass. Correcting the stoma, unfortunately, would be something like Stomaphyx that does not work either.
Also, if you end up self pay I certainly wouldn't get a band over your bypass, it's quite unlikely to work.
Previously Midwesterngirl
The band got me to goal, the sleeve will keep me there.
See my blog for newbies: http://wasabubblebutt.blogspot.com/
The band got me to goal, the sleeve will keep me there.
See my blog for newbies: http://wasabubblebutt.blogspot.com/
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