Jersrose43

Many on this forum have found insurance available to them now that ACA is in effect. Many were self pay or just denied for précis ting condition.

I love that we all "blame" Obama, ACA, the hospital etc The first thing I thought of when she said the hospital future goals isn't bariatric was the fact their morbidity rates were probably high? It takes a lot for a hospital to stop offering something like this and usually it's because too many things went wrong along the way I would see this as a blessing if you believe in karma. You should check with your states insurance commissioner, google search for morbidity rates at the facility. Unfortunately many times the rates you find on the internet are several years old.

Good luck!!!

They can totally force you to FMLA and it's better for you because it protects your job The question is can they layer your STD with your FMLA. If yes. Then you are paid to be out of work. But if they won't later you are no pay for up to 12 weeks. I am getting two weeks STD and up to 12 of no pay FMLA. Either way she can't post my job or hire someone to take over while I am out. FMLA prevents that

I plan on applying for short term disability I told my boss she had a negative viewpoint. She does not control my std benefits nor does my HR dept. We all have FMLA in the us ---- USE IT! It is your right to keep to yourself or share. I have told a couple coworkers am considering 1- what? you're not that fat! 2- whatever support you need let me know I am here for you My boss - you don't need that. I am going on a diet to we can support each other. I do not approve of you doing this. That was 3 months ago. Haven't diacussed it with her since.

I am starting to feel like I didn't get what I paid for with this post. I paid $175 It took 15 minutes. I spent more time driving to and from his office then sitting in it. I filled out paperwork for 15 minutes, including drawing pictures of self image and trees and houses. Spent 10 minutes with the shrink. Done. 45 minute drive both ways He billed my insurance for $525. They approved $375 and went to my deductible. Thank goodness I got a paid in full receipt for the $175. Because his office manager wanted the balance. As if.

As a person waiting for approval and committing to this journey .... I really appreciated this post. You see I am not a food addict. I don't eat unhealthy. I consider my food choices daily optimal ones. I have tried practically every diet out there unsuccessfully. I've met with nutritionist after nutritionist. Tried diff things only to GAIN weight on a "DIET" supervised or otherwise. And then pack on the extra 10 pounds to the baseline every time. Excercise is difficult as I suffer from increasingly worse asthma every day and I run out of breath. Compounded by my weight yes. I don't eat chocolate but occasionally I don't eat burgers but occasionally Pizza maybe once a month The worst thing i do? Date night with hubby once every two weeks. We like to try new and exciting places. That's the worst I do and always overindulge. We've agreed going forward after I am back on solids it's once every other month. And no overindulging. I have 3 meals a day. I don't have multiple small meals a day - tried that gained 7 pounds No thyroid issue found but family is rampant with them so it's a matter of time. I need this tool. It is time. I plan on being as religious as possible. I have accepted that weight loss may be rapid or may be slow. That some days I will stray and it will be ok as long as the long term goal is the lifestyle acceptance and to be healthier. I do not see this as a diet. I appreciate the posters saying this because measuring everything was probably one of my biggest concerns. The mountain before me and all.

At first I read this and then thought this could be my husband writing this. We r at 20. I said I would like a 3 day trip somewhere. Vegas or AC or Quebec. Whatever go figure it out, book it and fill me in. Yep he can book it. I thought it was fine and I didn't plan anything that night. I made dinner, nothing special, we ate after kids went to bed but that's it. He brought home flowers card etc and I got pissd off. Yep u heard it. I was pissed. Yes it was nice and romantic but we agreed a 3 day trip so why the expense and waste of flowers etc. A gift. I mean I thought we communicated here. And you immediately jump to the fact it's because of your weight? Why ? I didn't read any of his actions or non action to do with that at all. His reason was because he can and he wanted to. So ok I could've also but I didn't. He wasn't overly hurt. He told me a card would've been nice. I said on the AC trip you'll get a card and then some. I think you need to talk.

At first I read this and then thought this could be my husband writing this. We r at 20. I said I would like a 3 day trip somewhere. Vegas or AC or Quebec. Whatever go figure it out, book it and fill me in. Yep he can book it. I thought it was fine and I didn't plan anything that night. I made dinner, nothing special, we ate after kids went to bed but that's it. He brought home flowers card etc and I got pissd off. Yep u heard it. I was pissed. Yes it was nice and romantic but we agreed a 3 day trip so why the expense and waste of flowers etc. A gift. I mean I thought we communicated here. And you immediately jump to the fact it's because of your weight? Why ? I didn't read any of his actions or non action to do with that at all. His reason was because he can and he wanted to. So ok I could've also but I didn't. He wasn't overly hurt. He told me a card would've been nice. I said on the AC trip you'll get a card and then some. I think you need to talk.

At first I read this and then thought this could be my husband writing this. We r at 20. I said I would like a 3 day trip somewhere. Vegas or AC or Quebec. Whatever go figure it out, book it and fill me in. Yep he can book it. I thought it was fine and I didn't plan anything that night. I made dinner, nothing special, we ate after kids went to bed but that's it. He brought home flowers card etc and I got pissd off. Yep u heard it. I was pissed. Yes it was nice and romantic but we agreed a 3 day trip so why the expense and waste of flowers etc. A gift. I mean I thought we communicated here. And you immediately jump to the fact it's because of your weight? Why ? I didn't read any of his actions or non action to do with that at all. His reason was because he can and he wanted to. So ok I could've also but I didn't. He wasn't overly hurt. He told me a card would've been nice. I said on the AC trip you'll get a card and then some. I think you need to talk.

I know my carrier required more than that They wanted to monitor my diet - so they had to send in what I ate But I don't have uhc You can try

It's really sad when doctors offices set wrong expectations. If it's a benefit exclusion it definitely will not be paid for regardless of medical reason Call your insurance and confirm it's a benefit exclusion

That's awesome

Correct benefit exclusion is just that. No matter what code they use that procedure no matter the need will not be paid for Get on a spouse plan if at all possible If not purchase individual jnsurance that has the benefit - check and trike check Last resort you'd have to pay cash

Yes you're rigt I misread. So you may need one more visit? Maybe? I can't see them being that particular but I am also on reconsideration with Cigna right now But it's because insurance coordinator messed up and did not send any documentation with the request.

I read it as you have the requirements. You have 3 consecutive months (feb, March, April in less than or equal to 90 days) The only thing am not sure about is your 2nd doc. Did you get a letter from your PCP recommending surgery and medically clearing you for surgery?

Have you thought of either joining your husbands health plan or purchasing a plan through obamacare? Just do the research and confirm it's covered first and buy the plan. The monthly expense would be less than a full out of pocket. I would consider it best to buy a plan since I am concerned about paying for pre and post care complications

Sounds like a benefit exclusion and if that's the case no appeal for medical necessity will be useful at all. Call PBA as soon as you can and verify if it's a benefit exclusion or something else as soon as possible. This way you won't waste your time on unnecessary appeals

Hi saw this old thread with dr bessler. Am starting the journey with him at valley in New Jersey Wonder how you ladies did post op and how you're doing today?

Am going to call the appeal number tmmw and pull the files they sent over. I am so disappointed. I know that trying an appeal makes it harder. She should just have sent everything in the first time correctly.

I work for my insurance carrier

United Aetna and Cigna business is mostly self funded coverages. Meaning your employer buys their plan and customizes it to fit their needs of what they want to pay for. They can customize everything including the benefit and the requirements to get the surgery. The employer pays for the actual services and an administration fee. No monthly premiums. True insurance pays a monthly premium and you get a plan of coverage.

Research the private plans available on healthcare.gov and pick one of those up for a year and get the surgery done. $800-1000 a month is a lot Cheaper than 18k

She submitted the paperwork to the insurance two weeks ago. I had no idea she had done this I had not even spoken to her once about it. I just finished going through all the visits and preps and stuff. So surprise I get a letter from Cigna saying they need more information last Thursday They need the notes on the 3 months visit with nutritionist and pcp letter. I picked up pcp letter Monday and scanned and sent it over to her. That was the 21st. Mind you 3 months of NUT visits were conducted in her office. She didn't send with original request She says she would send over letter from pcp on Monday. Ok. On track now. So yesterday I open the mail and there is the rejection dated the 25th. Not medically necessary because why? No NUT notes!!!!!!!! No letter from PCP!!!!!!!! Nothing indicating comorbidities - which is in the pcp letter and if she was doing her job reading her own office notes. she would've seen I have high blood pressure and asthma. Can you say friggin pissed at stupidity! So needless to say I will be on her ass on Monday morning.

You have to apply through the affordable care act. Healthcare.gov. If you qualify for Medicaid you likely will be forced to keep that. If you can afford health insurance very month you won't be on Medicaid and likely will lose your status