When it rains it pours

navyrob74
on 8/29/14 2:34 am - Pasadena, MD

I am in month 4 of my required 6 month wait to get my RNY. All my test are done and I have been cleared from head to toe. When out of the blue today I get a call from my surgeons office telling me that my surgeon is leaving the practice and I will be placed with the other doctor in the office. ( who I have never met or seen) so I am starting to panic because it took me a while to find this one and the office is acting like it is no big deal. That was the rain and now for the pour. Our insurance coverage currently is with Coventry and it has a high deductible which was a really hard to meet this year even with a wife and 3 kids. Today we recieved a letter saying our insurance is not going to be renewed because of changes in the plan so effective 12/1 we have no more coverage. Which leads me to think that there is no way they are going to pay for the surgury now since they know they will not be covering us after 11/30. It was already going to be tight trying to get it approved since my 6 months is up 10/1 but now I feel like putting my head in the sand and rasing the white flag. I am not sure if anyone else has ever felt like this but it seems like the closer I get to this the harder it becomes.

Nola68
on 8/29/14 3:23 am

Sorry you are going thru this.  I would make an appointment to meet with new doctor, maybe you will like him better  I would go ahead and try for insurance approval, after all you are still covered until 11/30.  Do you have a surgery date?  Good luck!!!

  

67 Years old - HW 252 - SW 231 - CW 149 - GOAL 145  RNY 7/22/2014

 

navyrob74
on 8/29/14 3:30 am - Pasadena, MD

No I dont have a surgery date yet, the doctors office will not submit it to the insurance until the 6 months are complete so that leaves me an 8 week window to get approval and surgery.

NYMom222
on 8/29/14 4:21 am
RNY on 07/23/14

Most insurances allow them to submit before the 6-month mark, as long as the surgery doesn't occur before then. Under the cir****tances, maybe they would submit early. The insurance people in the office should know the usual turn around time as well. for me they told me it would take 7-10 days to hear, and they were right. ALso under the cir****tances maybe they will put you on the calendar.

Cynthia 5'11" RNY 7/23/2014

Goal reached 17 months. 220lb Weight Loss
Plastic Surgery Dr. Joseph Michaels - LBL and Hernia Repair 2/29/16, Arm Lift, BL, 5/2/16, Leg Lift 7/25/16

#lifeisanadventure #fightthegoodfight #noregrets

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aweis
on 8/29/14 8:49 am

Hi Rob,

I am in Pasadena Maryland also. I had Dr. Averbach from St. Agnes. He is wonderful.

Good Luck feel free to private message me if you need anything.

Amy

navyrob74
on 8/30/14 12:59 am - Pasadena, MD

Thanks Amy, I thought about changing doctors but I am worried they are going to make me start all over again. I really feel like my back is against the wall now with very little choices

NoDaybut2Day
on 8/30/14 3:22 am - CA
RNY on 07/03/14

One of the best gifts I ever received from my ex was to learn you don't know until you ask.  Don't assume anything!  Go out there and ask everyone you can, your doctor's office, different doctor's offices until you find the answers that will help you!  I have Kaiser so it doesn't apply, but I know my doctor wouldn't have made me wait 6 months before moving ahead.  Don't despair.  There are surgeons out there who want to help and to get paid themselves.  Best of Luck!!!!

 HW: 308,  CW: 261,  SW: 240,  Now: 135.8  M1: -23.4  M2: -12.0 M3: -10.2 M4: -10.0 M5: -9.0  M6: -10.0  M7: -2.0  M8: -6.8  M9: -7.6 M10: -4.6 M11: -3.6  M12: -3.7  M13: -1.2

    

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