jillagin2000
Just me, right now, in a nutshell
Jan 21, 2009
I was scheduled for revision to RNY in October 2008 only to find out 2 days before surgery that United Healthcare (read Spawn of Satan) denied me coverage. Get this, the cited their 5-year minimum 40 BMI rule. The jerks shouldn't be able to get away with that. Rules are all well and good but in healthcare especially every case should be judged on its own merit and clearly a revision patient shouldn't have to meet that particular criterion.
So, I contacted obesitylaw.com and Kelley and Walter Lindstrom wrote some fantastic appeal letters for me all to no avail. I decided in November, during my company’s open enrollment period, to switch my insurance over. I verified that UPMC doesn’t have any outright exclusion first though J
In the interim I learned about the DS, and I really like the DS at least what I’ve read about it. But there are so few “real DS” surgeons in the US and none of them are on my plan. My plan does not even have an out-of-network option. It’s their network or self-pay. So, then I had to decide, do I attempt to fight for the DS with UPMC – try to get them to pay for an out-of-network provider like Dr. Husted? I don’t think I can win that battle any more then I could if they had an exclusion for WLS entirely. Or I could wait and choose United Healthcare for 2010 and then re-engage Walter and Kelley to fight them for at least another year.
Facing a 1-2 year fight with no guarantee of success to get a DS and comparing that against the guarantee that I can get the RNY within a month I chose to get the RNY. I based my decision on more factors then that. My mom has been VERY successful with her RNY and her quality of life is just fine. I’d have no problem with her results or her relationship with food though I will learn from her mistakes and take my vitamins for the rest of my life :-)
I'm now scheduled for revision to RNY on 2/4/2009!!
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I'm now scheduled for revision to RNY on 2/4/2009!!
