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

Just Found Out My Insurance Changes 2013



Recommended Posts

Now they are saying its just a covered service. But it was ok before. I don't know what the heck they are doing there. GRRR

***its not a covered surgery

Share this post


Link to post
Share on other sites

Doesn't look like I will part of the family ; '( so sad, disappointed, and angry.

Share this post


Link to post
Share on other sites

Doesn't look like I will part of the family ; '( so sad' date=' disappointed, and angry.[/quote']

I'm so sorry can u do the bypass?

Share this post


Link to post
Share on other sites

Yeah I can but I do not want to go that route. My other primary(rheumatoid and primary) drs told me not to have that done. So my only other choice is lap band. I dont think that gives me enough help. I dont know...I'm so torn. I will be appealing for sure and see where it goes and possibly contacting a lawyer since they previously said It was an approved service.

Share this post


Link to post
Share on other sites

Yeah I can but I do not want to go that route. My other primary(rheumatoid and primary) drs told me not to have that done. So my only other choice is lap band. I dont think that gives me enough help. I dont know...I'm so torn. I will be appealing for sure and see where it goes and possibly contacting a lawyer since they previously said It was an approved service.

I'm glad to hear u haven't given up!!

Share this post


Link to post
Share on other sites

Thanks :)

Share this post


Link to post
Share on other sites

Just found out my insurance is changing 2013. And now WLS will not be covered at all!!! And my surgery was going to happen Jan/Feb. I sure hope I can have this WLS still since I started earlier this year 2012. Keeping my fingers and toes crossed. I will call my case manager at the insurance company on Monday. #stressing

This exactly why I did the WLS yesterday. Part of me would have preferred waiting longer, but our new insurance would not cover it in 2013

Share this post


Link to post
Share on other sites

Yeah I wish I had that option.

My complex case manager called me today and said my bypass was covered and I waa ready to go. I said uhhhh no I am not doing that.

So I told her how PISSED off I am and that I would take other measures. She asked me what those were and I said I am contacting our state dept of insurance to file a formal complaint against them and if needed I would be hiring a lawyer!

She was like...ohhhh dont do that! She said dont do anything until I can talk to my manager. She has until Friday and next Thursday I file the complaint. I REFUSE to take no for an answer. I'm very determined ..especially since it was their mistake. We will see how it goes

Share this post


Link to post
Share on other sites

Ok......so after threatning them to Dept of Insurance they have FINALLY put in approval for the sleeve!!!! About time! Now just waiting for a surgery date!!!!

So excited

**thanks for listening (:**

Share this post


Link to post
Share on other sites

I got my date yesterday!!!!! Feb 14th (which is also my husbands birthday)

Everything is a go. I asked them what happened and they said they changed the verbiage in my policy? So I think what happened was they just added it as they knew they messed up. Either way I am good with it. I also requested a copy of the new verbiage so I can show this to my "lawyer". My lawyer is a friend who is a paralegal who her boss/friend is a lawyer. I just want them to look it over for any hidden issues. Ins coordinator assures me there is not anything to worry about. Hmmmm no thanks give me a copy (:

Share this post


Link to post
Share on other sites

I got my date yesterday!!!!! Feb 14th (which is also my husbands birthday)

Everything is a go. I asked them what happened and they said they changed the verbiage in my policy? So I think what happened was they just added it as they knew they messed up. Either way I am good with it. I also requested a copy of the new verbiage so I can show this to my "lawyer". My lawyer is a friend who is a paralegal who her boss/friend is a lawyer. I just want them to look it over for any hidden issues. Ins coordinator assures me there is not anything to worry about. Hmmmm no thanks give me a copy (:

Good for you for fighting!! Congratulations on getting your date!

Share this post


Link to post
Share on other sites

Congrats. Thats a crazy story but glad it worked out!

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

    • Theweightisover2024🙌💪

      Question for anyone, how did you get your mind right before surgery? Like as far as eating better foods and just doing better in general? I'm having a really hard time with this. Any help is appreciated 🙏❤️
      · 2 replies
      1. NickelChip

        I had about 6 months between deciding to do surgery and getting scheduled. I came across the book The Pound of Cure by Dr. Matthew Weiner, a bariatric surgeon in Arizona, and started to implement some of the changes he recommended (and lost 13 lbs in the process without ever feeling deprived). The book is very simple, and the focus is on whole, plant based foods, but within reason. It's not an all or nothing approach, or going vegan or something, but focuses on improvement and aiming for getting it right 80-90% of the time. His suggestions are divided into 12 sections that you can tackle over time, perhaps one per month for a year if a person is just trying to improve nutrition and build good habits. They range from things like cutting out artificial sweetener or eating more beans to eating a pound of vegetables per day. I found it really effective pre-surgery and it's an eating style I will be working to get back to as I am further out from surgery and have more capacity. Small changes you can sustain will do the most for building good habits for life.

      2. Theweightisover2024🙌💪

        That sounds awesome. I'll have to check that out thanks!

    • BeanitoDiego

      I've hit a stall 9 months out. I'm not worried, though. My fitness levels continue to improve and I have nearly accomplished my pre-surgery goal of learning to scuba dive! One dive left to complete to get my PADI card 🐠
      I was able to go for a 10K/6mile hike in the mountains two days ago just for the fun of it. In the before days, I might have attempted this, but it would have taken me 7 or 8 hours to complete and I would have been exhausted and in pain for the next two days. Taking my time with breaks for snacks and water, I was finished with my wee jaunt in only 4 hours 😎 and really got to enjoy photographing some insects, fungi, and turtles.
      Just for fun last week, I ran two 5Ks in two days, something I would have never done in the past! Next goal is a 10K before the end of this month.
      · 0 replies
      1. This update has no replies.
    • Teriesa

      Hi everyone, I wrote back in May about having no strength. I still get totally exhausted just walking from room to room, it’s so bad I’m using a walker with wheels of all things. I had the gastric sleeve Jan. 24th. I’m doing exactly what the programs says, except protein shakes. I have different meats and protein bars daily, including vitamins daily. I do drink my fluids as well.  I go in for IV hydration 4 days a week and feel ok just til evening.  So far as of Jan 1st I’ve dropped 76 lbs. I just want to enjoy the weight lose. Any suggestions or has anyone else gone thru this??  Doctor says just increase calorie intake, still the same. 
      · 0 replies
      1. This update has no replies.
    • Stone Art By SKL

      Decorative Wall Cladding & Panels | Stone Art By SKL
      Elevate your space with Stone Art By SKL's decorative wall claddings & panels. Explore premium designs for timeless elegance.
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      Losing my hair in clumps and still dealing with "stomach" issues from gallbladder removal surgery. On the positive side I'm doing better about meeting protein and water goals and taking my vitamins, so yay? 🤷‍♀️
      · 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

    ×