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

Losing my monthly fills ins coverage due to Obamacare come Jan 2014



Recommended Posts

And just t add I don't think its Obamacare. Lots of insurers don't like covering bariatric stuff because it's expensive especially if you go monthly and have other health issues.

Share this post


Link to post
Share on other sites

As far as keeping your own insurance- yes you can. However, there are very strict stipulations to that. When "day 1" happens and Obamacare is fully active, if you have insurance through an employer you can keep it. You will then be grandfathered in at whatever your current coverage is (though there's no guarantees on premiums). However, if you leave that coverage at any time, you CAN NOT go back to the same plan. If you get married, your spouse would have a different plan than you. If you had a baby, same thing. Essentially you could work with a new employee at the same company and you could have totally different insurance because you were grandfathered in and they were hired after "day 1".

This is what the actual Obamacare bill says, btw.

Missy, I was informed in a letter from Anthem BCBS that they had chosen a different policy for me that would best suit me based on my health due to the new Obamacare that is coming Jan 1 and that I couldn't be grandfathered in because I didn't have this ins in 2010 I got it in 2012 and I'm not employed. I was strictly told what I was getting and had no choice in the matter, however with that said, I was just about to post, my premium is going down from 555.91/mo to 383.00/mo but they will no longer cover bariatric surgery of any kind anymore nor bariatric aftercare so I will lose that and if I ever have to need a revision of any sorts I SOL...Also my copay is 40.00 come Jan and now its 25.00 so to me this is all socialism and it all sucks for me in the end.

Share this post


Link to post
Share on other sites

here I will lay it out for you folks. I will have a deductible of 2500.00/yr, which I will never meet but I did this year due to a hospital stay in Nashville that was an emergency but am having to pay out of pocket for some of that and also I had a cancer screening colonoscopy done since my brother is battling cancer right now my choice so there again, went towards my ded., and paying towards that also so I met my ded this year but next year I don't foresee any major medical problems. My ins will change come Jan 1 to only 3 visits to my PCP with me paying 40.00 copay and any visits after that I pay 20% out of pocket towards my ded. I asked my lapband surgeon today which I went for a fill and he told me for me he would charge me 75.00 for a fill, I thought whew, I can handle that a month until I get in the green zone, what a blessing. Yes I live on a strict budget, I only get paid alimony as I can't work and live with my mom cause I can't make ends meet on my own. I honestly think that the money I will be saving each month in premium will even itself out with deductibles and fills but we will see. I do get sick a lot and I do see a pych for sleep therapy and other issues. I sure hope my RX stays the same as my meds run me thru the roof right now or shall I say maybe changes and gets better...Anyway nothing I can do about it, it's gona happen whether we like it or not.

Share this post


Link to post
Share on other sites

my ins pays for my fills (hadnt had one yet) but when i do, i just pay a 12 co pay....like with my dr visits....had me doing a WTF head shake reading some of this stuff

Yep, insurance pays for my fills, too. And pays for all other aftercare I've gotten so far. Hopefully, with all that's going on with insurance, that will not change. I'm concerned, though.

Share this post


Link to post
Share on other sites

My client just received a notice from Anthem, that their existing small business policy will not be renewed.....that they will receive other options to pick from. My comment to my client was "and so it begins". This is just the tip of the iceberg.

Share this post


Link to post
Share on other sites

Missy I didn't mean to sound like I was attacking you, you are like my rock star girl and I love ya! Sorry if I came across that way in the above comments.

Share this post


Link to post
Share on other sites

I just checked the Megaflex benefits 2014 package that came from my husband's work. Thank God we can keep what we've had, which INCLUDES bariatric coverage. Phew.......good for another year. I was starting to sweat, reading all this sh-it.

Share this post


Link to post
Share on other sites

Thanks to Pres Obama my ins is changing and no longer will cover bariatric anything and I cannot afford fills and I'm nowhere near the green zone yet. I certainly don't know what I'm going to do. I do not work' date=' can't, can't get disability, the only income I have is alimony and with me paying for health ins and other medical bills I barely have enough to live on, that is why I live with my mom since my divorce, thank God I at least have a roof over my head. I'm heartbroken over this news. I'll be in debt up to my eyeballs and then some because I see him every month for a fill.[/quote']

Hi.....I know you said this is due to healthcare reform but lots of companies are taking an opportunity to cut there spend on healthcare becaise of increased cost albeit some of it due to healthcare reform but I work in benefits and I can tell you that healthcare reform doesnt require it. My companies program still provides it and we are fully compliant with the requirements set out under the ACA/healthcare reformm

It really stinks that the insurance compqny has chosen this path as good health is a way to "avod" future increased health expenses and its too bad many insurers dont see the value in that. I agree with some of the other posts, look into payment plans and even healthcare exchanges to see what prices and plans you would be eligible for.

Best of luck to you!!!

Share this post


Link to post
Share on other sites

:(

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

    • ChunkCat

      I have no clue where to upload this, so I'll put it here. This is pre-op vs the morning of my 6 month appointment! In office I weight 232, that's 88 lbs down since my highest weight, 75 lbs since my surgery weight! I can't believe this jacket fit... I am smaller now than the last time I was this size which the surgeon found really amusing. He's happy with where I am in my weight loss and estimates I'll be around 200 lbs by my 1 year anniversary! My lowest weight as an adult is 195, so that's pretty damn exciting to think I'll be near that at a year. Everything from there will be unknown territory!!

      · 3 replies
      1. AmberFL

        You look amazing!!! 😻 you have been killing it!

      2. NickelChip

        Congratulations! You're making excellent progress and looking amazing!

      3. BabySpoons

        So proud of you Cat. Getting into those smaller size clothes is half the fun isn't it?. Keep up the good work!!!!

    • BeanitoDiego

      I changed my profile image to a molecule of protein. Why? Because I am certain that it saved my life.
      · 1 reply
      1. BabySpoons

        That's brilliant! You've done amazing!! I should probably think about changing my profile picture at some point. Mine is the doll from Squid Games. Ironically the whole premise of the show is about dodging death. We've both done that...

    • eclarke

      Two years out. Lost 120 , regained 5 lbs. Recently has a bout of Norovirus, lost 7 pounds in two days. Now my stomach feels like it did right after my surgery. Sore, sensitive to even water.  Anyone out there have a similar experience?
      · 0 replies
      1. This update has no replies.
    • Eve411

      April Surgery
      Am I the only struggling to get weight down. I started with weight of 297 and now im 280 but seem to not lose more weight. My nutrtionist told me not to worry about the pounds because I might still be losing inches. However, I do not really see much of a difference is this happen to any of you, if so any tips?
      Thanks
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      Well recovering from gallbladder removal was a lot like recovering from the modified duodenal switch surgery, twice in 4 months yay 🥳😭. I'm having to battle cravings for everything i shouldn't have, on top of trying to figure out what happens after i eat something. Sigh, let me fast forward a couple of months when everyday isn't a constant battle and i can function like a normal person again! 😞
      · 1 reply
      1. kezbeth

        I may have to have gall bladder surgery during my weight loss surgery. Not thrilled about it either but do not want 2 recovery times. Just want it over with.

        Thanks for your post. I may need to rethink my decision... :(

  • 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

    ×