Jersrose43

I was a major eat out before surgery and still am. It requires a change in lifestyle and choices not social life Example late Saturday me and hubby date night at biggies. 6 raw clams I had 3. And then for entree I ordered jumbo shrimp cocktail. It comes with 5. I managed 3. Done. I am now a cheap date. Or leftovers Are you familiar with yelp? Have been a yelp elite for over 3 years and I intend to keep my status! Just make better menu choices

Yes just watch them as they melt. Took me couple times to get it not to burn to a crisp

File for FMLA and tell them them to kiss your ass. My elective surgery was covered by std and FMLA guidelines. I had no issues

Pickles olives and cheese chips Get shredded cheese make little mounds on well greased aluminum I use toaster oven for 4 minutes melts them to a chip. They're great

Do you have documented proof of the problem? Medical records at physician with complaints?

It's 7.5 for those aged 65 and over and 10 for the rest of us It's a % of your taxable income. So if you made 100,000 but you're taxable is 95,000 then 10% is 9,500 Now if you have an HSA or other pre tax account to reimburse yourself you are further challenged

Yes every time someone snaps a picture of me now vs then. I totally feel you!!!

You're working out that much you may need to increase your calories. I think you aren't taking in enough calories for your body to give up the weight.

Not all employers offer std with a %of your check. Many offer std with 0 pay FMLA will protect you while you are out. You cannot be penalized for being out (ex you didn't finish that paper by x date you're fired - you were on PTO is not an excuse should've cancelled PTO) God forbid something happens and you're out for a long time. They can't post your job and offer it to someone else for at least 6 months. And then they have to guarantee you a job to come back to because it FMLA protections. Std and FMLA go hand in hand. File the paperwork for FMLA and go thru that process. If you decide to get full pay for it and go pto then cll the std carrier AFTER your surgery and retract the filing. Talk to your hr department to understand if you can do that. My employer is full std pay but my former employer was 0 pay for std. I filed with my former for a nasal surgery and then was able to retract it as I was able to be up and working from home after 2 days.

Donald if you submit and it hasn't been 89 days it will likely be rejected. Once you get a rejection the next step is not a resubmission it is either a peer to peer review or an appeal from your provider. Both take longer than the normal first time submission Trust me that I totally understand the oop dilemma. I really feel it since I had $9000 of it myself and so was pushing for everything in this one year. I would suggest you get together any medical records that show you've been treating with a physician and medically monitored this year before the surgeon and see if they will consider that. Your surgeon will know. Also call your insurance. Sometimes employers allow any deductibles incurred last month of the calendar year to carry to the new year. Long shot but worth a try.

You should be ok that is how I had mine. At least one a months. Not two in same calendar month

For Cigna you really need 89 days. Look back thru responses I have attached the medical policy

I used FMLA it was a surgery and I qualified and so why not?

I agree with you. The hoops can be a good thing. Especially in this life altering decisions

Opt out is one thing. Choosing to not go thru "hoops" is something I will do considering my cost per year for premium is close to $2000 a year. So if it's covered I find out the guidelines and make sure I meet. Then I pay my deductible and coinsurance And yes it's more expensive than Mexico but I can go 10 miles and see my surgeon whenever I need to.

I pay enough for my coverage evry week - it's called holding them accountable to pay for services

Your employer can require more than normal but the 6 month is a little unusual that's why I asked if it was a third party. We sell to other insurances and they use our rules and networks and administer some additional authorization rules

Are you speaking to customer service when you call or are you telling the computer it's in regards to authorization? Tell computer authorization after medical Then tell them tou are reading the policy (I posted link earlier in this post) and that it reads three months Ask them why your policy requires 6? Is it your employer or the third party payer policy?

Center of excellence is normal saves more money. The 6 months is odd. Call Cigna directly and confirm that. Don't rely on the doc coordinator

I think it matters why you got denied, were both your insurances provided by the same employer? If so it was likely an employer restriction, which means you can get other insurance privately, switch employers or get it through a spouse and obtain coverage. Just takes more research.

Since i work in insurance over 20 years -- you're overreacting. All authorization approvals contain this caveat, because just because you are authorized today, doesn't mean you will have insurance tomorrow. You could forget to pay your premium, your employer can terminate and switch coverage, you could get a divorce and no longer be eligible for coverage. Basically its an eligibility caveat. You're overreacting.

Electronic medical records aren't signed. I would think that is not an issue. Also - why are you doing 6 months? See the link i posted several pages back, Cigna requires an 89 day monitoring, not 6 months.

Best of luck KStuz.

I would pick 2-3 options and then start making phone calls and googling. Questions you'll want to ask: 1. Is the plan offered through the exchange going to cover WLS? 2. Can you send me the medical policy for that specific exchange plan in writing? 3. If that plan does not cover WLS, which plans do you offer to an individual that will and what is the cost?

I work at home, i understand perfectly. Here is what i did to make it "better" First, I moved upstairs. The office was on the first floor and i went out of my way to move everything up to the 2nd floor. It forces me to be further away and actually have to consider getting up and walking down. Second, I bring up my Water for the day, I fill a 30 ounce bottle first thing in the am. Take my yogurt or oatmeal for Breakfast, my drink and get on line by 9. Third, around 10:30/11:00 - I plan a 15 minute break around this time, and go downstairs and grab my snack (cottage cheese, or cheese stick, or fruit) and refill my water. I also grab about 10 almonds. This way if i do want a snack i have pre-measured amount and track/log it. I make sure that i have no food at al in my office or near me unless it is for lunch/pre planned Snacks etc.