Please Help Insurance is just wreckn my nerves!!

Rachel P.
on 5/18/10 12:19 pm
Hello everyone. I hope that u can help me out.. I'm just abt to lose my mind here.. I've been calling abt supplemental Insurance, or Medigap. Whatever its called cuz at this point I'm just confused. I will be eligible for Medicare on 06/01 of this yr. I'm under the age of 65 & I am already doing my diet eval w/my NUT thru my Dr's advice. Just so I can show that I've started my pre-op diet for I need documentation 4 7months. My problem is that the Medigap/Supplemental Ins. is just really confusing the hell out of me. We all know that we need help to pick up the 20% that Medicare will leave us with so I've been researching calling different companies and finally decided to call Humana Ins.. I spoke to a rep & he told me that Why didn't I get into Humana Texas Go Plus HMO?? He xplaind 2 me that basically Medicare would take a step bak & that Humana would now be my Ins. & that I would have to follow their guidelines. He also informed me that the Ins. premium w/vision & dental would be like $19 per month??? I mean is that right?? I'm telling u I'm just so confused that I want to pull my hair out!!! I am on going on my 3rd month eval and now everything will change if I make this decision.. Plus I spoke to an advocate @ my Dr's office trying to get some advice seeing as how they work w/patients Ins. companies and all & she tells me that I should try Humana cuz they weren't as strict as Medicare & I wouldn't have to worry abt the 20% that Medicare would leave... I'm so happy cuz I'm finally gonna have ins to start the process such as tests, blood work, sleep study now that Medicare is gonna kick in n I've started to feel more like a reality for me that this is happening n to find out I might have to consider to go another way is just really trippin me out!! Can someone please hellp me w/this?!? I've been stressing so hard that its starting really take a toll on me. Hope to hear from u soon...

Rachel
cindy31
on 5/23/10 12:08 pm - Gwynn Oak, MD
I am a medical biller and I have worked for both medicare part A&B, basically Humana would be  a Medicare supplemental plan that would take the place of Medicare, you want to research what their reuirements are for weight loss surgery , do they reuire a center of excellence like medicare does and is their any deductibles, copays or coinsurance, do you have ant out of pocket limits or requirements and make sure your surgeonn accepts the insurance, your other option is to purchase a secondary insurance policy that will pick up the balance remaining afte medicare has paid, or if you are elgible for medicaid that could be another possibility but just make sure they will pay secondary on bariatric surgery. whether you choose a secondary insurance or medicare supplement make sure to find out if auth is required and what your out of pocket expenses will be for the surgery if any , I do know that medicare does not require the 6 month diet but the surgeon may.
            Highest weight- 325  Day of surgery- 301  Post surgery -306            
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