Jump to content
×
Are you looking for the BariatricPal Store? Go now!

(Chicago) New insurance does not cover Fills, please help.



Recommended Posts

Well I know right now because I just got the news I might be over reacting but I'm heart broken.

I had my surgery on June 5th. My insurance covered everything! I didn't pay a dime. I had a couple fills last year and then my husband's employer changed to United HealthCare Choice Plus and I had to find a new doctor that was "in-network". So I thought I found one, I had my fill scheduled for today (I SOOO NEED IT) and I just got a call that our new insurance doesn't cover bariatric at all. So in order to get my fill there I would need to pay $250.

Now I know that there has to be places that are cheaper. Can anyone suggest some in my area? I live in Chicago but can drive to the suburbs if need be. I'm just worried now, God forbid, something went wrong in the future then what? :wink:

So sad. Thanks.

Share this post


Link to post
Share on other sites

That sucks! I have UHC choice plus also and they cover everything! It must be the employer. Sorry to hear about your difficulties.

Share this post


Link to post
Share on other sites

It has to be the employer... because I know that the new doctor I was suppose to see today is "in-network" for them so it must be something the employer asked to have removed from their policy.

Please if anyone can refer me to a place I can get a fill for cheaper I'd really appreciate it.

And to think I was upset about having to now pay a $40 specialist copay for fills now... :wink:.

Times are just hard.

Share this post


Link to post
Share on other sites

I live in Washington and had to self pay for my Band and will also have to pay for my fills. $250 is actually a good price for a fill. I have seen them between $175 (by a nurse) and $600. Pay the $250 with a good doctor and be happy you didn't have to pay for the surgery. You are blessed to have had the coverage to get the surgery.

Share this post


Link to post
Share on other sites

IF, my economic situation was diff., I would not be here trying to find a cheaper place to go. $250 is just NOT an option for me or my family at this point.

Thanks anyway.

Share this post


Link to post
Share on other sites

Sounds like you won't be getting a fill if you are unwilling to make a sacrifice and pay for it. A good majority of us on this forum sacrificed a lot and had to pay out of pocket for the whole thing... so i don't think you are going to get much sympathy on here for having to pay for a fill.

Glad you had good insurance and have not had to "pay a penny" so far. Maybe you can find someone on a corner somewhere that will inject you with something "cheaper"... but if you want a reputable doctor to do a real fill you will have to pay... and $250 is at the bottom of the fee scale for a fill... unless you are willing to risk problems.

Share this post


Link to post
Share on other sites

Wow, I guess working extra hours to pay the mortgage and child's tuition isn't enough sacrifice.

We sacrifice SO MUCH just to pay our necessities right now, please don't sit there and judge me assuming that I wouldn't sacrifice even MORE if I could. Not everyone has the same income, bills, children, tuitions, family members with other health related costs, etc.

I get what you are saying... you have no idea how much I prayed that my insurance covered my surgery. I praised God so much when it finally happened. I'm simply, due to MY OWN financial situation, trying to find thru fellow LapBanders, local referrals.

Have a great day.

Share this post


Link to post
Share on other sites

I don't see anywhere on her post where she was asking for sympathy, just help. No one knows this womans situation except for her self, so quit badgering her... She was just asking a question!

Share this post


Link to post
Share on other sites

You are correct... we don't all have the same bills/needs... some of us live within our means and take care of elder family members as well as our own children... some of us even do it after horible divorces that leave us homeless with nothing more than our smiles to get us started again. I do not have a high paying job, I am simply a hard worker who works my butt off to take care of my mortgage, 3 children, 83yo grandmother (with no Income), and myself. $250 is a lot of money to me... and takes me 3 days to earn... but without my health I can not provide for my family, so it is a priority to me.

Maybe you can pray for someone else to pay for it for you, so you can continue to pay for whatever it is you and your husband find as priorities.

Good luch in your search for a "cheap" doctor.

Share this post


Link to post
Share on other sites

Wow, so aggresive, you'd almost think I was asking YOU to pay it for me. Listen I wish you the very best in life. Good luck with it all. I still don't see how this affected you enough to go off like that but hey, to each their own.

jacelynn: thanks hun, I had to re-read my post just to make sure I didn't in fact ask for sympathy somewhere. LOL. Take care! And hopefully someone who isn't offended by my post will continue to share their opinions.

Share this post


Link to post
Share on other sites

IF, my economic situation was diff., I would not be here trying to find a cheaper place to go. $250 is just NOT an option for me or my family at this point.

Thanks anyway.

This is the post that set me off! I simply told of my research regardig pricing and that $250 is a good price for a fill and this is what I got... so Wahhhh... if you want to cry about it, and yell at people, go yell at your husbands employer! You don't need to be YELLING on here!

Grow up and quit expecting everyone to pay for your mistakes... no one got you fat, you did it on your own!

Share this post


Link to post
Share on other sites

Hm, I guess I'll be careful with my forum "yelling" from now on. Sorry about that. :eek:

I guess I'm the only fat person on here. :wink:

Share this post


Link to post
Share on other sites

Check back with your original doctor, if you haven't. Some give self-pay patients a bit of a break. I had one year of fills included, and that year is up. If I need additional fills, I think an in-office fill is just over $100 (although I forget how much it is exactly because I haven't needed one), but fills done under fluoro are around $700 (yikes!).

Maybe your surgeon would work out something for you since he did your band surgery in the first place.

Good luck.

Share this post


Link to post
Share on other sites

I hope it works out for you, MissMe. I understand that a doctor that didn't due the actual surgery might charge more for fills because he didn't get the money on the front end for doing the surgery, but hopefully the original doctor might work out something for you now that your insurance has changed.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Prdgrdma

      So I guess after gastric bypass surgery, I cant eat flock chips because they are fried???  They sell them on here so I thought I could have them. So high in protein and no carbs.  They don't bother me at all.  Help. 
      · 1 reply
      1. NickelChip

        It's possible for a very high fat meal to cause dumping in some (30% or so) gastric bypass patients, although it's more likely to be triggered by high sugar, or by the high fat/high sugar combo (think ice cream, donuts). Dietitians will tell you to never do anything that isn't 100% healthy ever again. Realistically, you should aim for a good balance of protein, carbs, and fat each day. Should you eat fried foods every day? No. Is it possible they will make you sick? Maybe. Is it okay to eat some to see what happens and have them for a treat every now and again? Yes.

    • NovelTee

      I'm not at all hungry on this liquid pre-op diet, but I miss the sensation of chewing. It's been about two weeks––surgery is in two days––and I can't imagine how I'll feel a couple of weeks post-op. Tonight, I randomly stumbled upon a mukbang channel on YouTube, and it was strangely soothing... is it just me, or is this a thing? 
      · 1 reply
      1. NickelChip

        I actually watched cooking shows during my pre-op, like Great British Baking Show. It was a little bizarre, but didn't make me hungry. I think it was also soothing in a way.

    • Clueless_girl

      How do you figure out what your ideal weight should be? I've had a figure in my head for years, but after 3 mths of recovery I'm already almost there. So maybe my goal should be lower?
      · 3 replies
      1. NickelChip

        Well, there is actually a formula for "Ideal Body Weight" and you can use a calculator to figure it out for you. This one also does an adjusted weight for a person who starts out overweight or obese. https://www.mdcalc.com/calc/68/ideal-body-weight-adjusted-body-weight

        I would use that as a starting point, and then just see how you feel as you lose. How you look and feel is more important than a number.

      2. Clueless_girl

        I did find different calculators but I couldn't find any that accounted for body frame. But you're right, it is just a number. It was just disheartening to see that although I lost 60% of my excess weight, it's still not in the "normal/healthy" range..

      3. NickelChip

        I think it's important to remember that the weight charts and BMI ranges were developed a very long time ago and only intended to be applied to people who have never been overweight or obese. Those numbers aren't for us. When you are larger, especially for a long time, your body develops extra bone to support the weight. Your organs get a little bigger to handle the extra mass. Your entire infrastructure increases so you can support and function with the extra weight. That doesn't all go away just because you burn off the excess fat. If you still had a pair of jeans from your skinniest point in life and then lost weight to get to the exact number on the scale you were when those jeans fit you, chances are they would be a little baggy now because you would actually be thinner than you were, even though the scale and the BMI chart disagree. When in doubt, listen to the jeans, not the scale!

    • Aunty Mamo

      Tomorrow marks two weeks since surgery day and while I'm feeling remarkably well and going about just about every normal activity, I did wind up with a surface abscess on on of my incision sights and was put on an antibiotic that made me so impacted that it took me more than two hours to eliminate yesterday and scared the hell out of me. Now there's Miralax in all my beverages that aren't Smooth Move tea. I cannot experience that again. I shouldn't have to take Ativan to go to the lady's. I really looking forward to my body getting with the program again. 
      I'm in day three of the "puree" stage of eating and despite the strange textures, all of the savory flavors seem decadent. 
      I timed this surgery so that I'd be recovering during my spring break. That was a good plan. Today is a state holiday and the final day of break. I feel really strong to return to school tomorrow. 
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Now that I'm in maintenance mode, I'm getting a into a routine for my meals. Every day, I start out with 8-16 ounces of water, and then a proffee, which I have come to look forward to even the night before. My proffees are simply a black coffee with a protein powder added. There are three products that I cycle through: Premier Vanilla, Orgain Vanilla, and Dymatize Vanilla.
      For second breakfast on workdays, I will have a low-fat yogurt with two tablespoons of PBFit and two teaspoons of no sugar added dried cherries. I will have ingested 35-45 grams of protein at this point between the two breakfasts, with 250-285 calories, and about 20 carbs.
      For second breakfast on non-workdays, I will prepare two servings of plain, instant oatmeal with a tablespoon of an olive oil-based spread. This means I will have had 34 grams of protein, 365 calories, and 38 carbs. Non-workdays are when I am being very active with training sessions, so I allow myself more carbohydrate fuel.
      Snacks on any day are always mixed nuts, even when I am travelling. I will have 0.2 cups of a blend that I make myself. It consists of dry roasted peanuts, cashews, pumpkin seeds, sunflower seeds, pistachios, and Brazil nuts. This is 5 grams of protein, 163 calories, and 7 carbs.
      Breakfast and snacks have been the easiest to nail down. Lunch and dinner have more variables, and I prepare enough for leftovers. I concentrate on protein first, and then add vegetables. Typically tempeh, tofu, or Field Roast products with roasted or sautéed vegetables. Today, I will be eating leftovers from last night. Two ounces of tempeh with four ounces of roasted vegetables that consist of red and yellow sweet peppers, sweet potatoes, small purple potatoes, zucchini, and carrots. I will add a tablespoon of olive oil-based spread, break up 3 walnuts to sprinkle of top, and garnish with two tablespoons of grated Parmesan cheese. This particular meal will be 19 grams of protein, 377 calories, and 28 grams of carbs. Bear in mind that I do eat more carbs when I am not working, and I focus on ingesting healthy carbs instead of breads/crackers/chips/crisps.
      It's a helluva journey and I'm thankful to be on it!
       
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×