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Divorce -- have to change insurance plan



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I'm divorcing and will soon have to change from my husband's excellent BCBS PPO insurance to my own company's plan. They offer a decent (so I'm told by coworkers) BCBS H M O and a pricey BCBS PPO. I haven't shopped for insurance in decades.

If I go with the PPO I can keep my primary care physician, my dermatologist and my band doctor. If I go with the H M O I have to switch bariatric teams. I'm still looking into the options and providers but I do know that I definitely want an office with fluoroscopy like I have now. It's also a Bariatric Center of Excellence which is important to me.

This change will likely happen in January if my husband is able to drop me from his plan during open enrollment. Not sure if it will happen then or later when the divorce is finalized, date unknown.

My question is, for those of you who have changed doctors with LapBand within the first year, what advice do you have for me?

I'm happy with my team but the only thing I dislike is the distance from work. The fills are hard to schedule because I can't get them after 4:30pm and it takes an hour to get there. Otherwise I am very happy. But to have a high monthly payroll premium deduction for the PPO is a big hit now as I'm starting over with two girls in private college.

I'm in the near west Chicago suburbs (DuPage). Anybody love their WLS doctor in this area?

Edited because bariatric pal didn't like the H M O abbreviation.

.

Edited by JustWatchMe

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All I know is if you choose the HMO then you have to g to those doctors and you have to get Referals for everything at least in Calif. and if you go with the ppo then you can chose any doctors that is just my opinion because as you know I have been trying to get my Mother on board , however I just found out that she has a hmo not ppo insurance and her pcp wil not authorize for her to have wls, so she would have to pay out of pocket , changing and making choices for insurance sucks , also there is a Lapband Surgeon 15 min. away from me and he wouldn't take me on , so now I drive a hr away for my fills , a lot of doctors won't take you if you have been going to someone else so take that in to consideration and do your research and ask questions if the other doctors are willing , and you also have to get your records so the new Doctors know , again just my opinion.

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I changed jobs and my new (crappy) insurance doesn't cover anything bariatric- and on top of that, my doc decided to stop practicing. I found a new doc, and for self-pay patients he has you pay $500 flat for a whole year of fills under fleuroscopy. You might shop around for something like that- and you could pay that out of an HSA or flex spend account.

I went in to see him, and one fleuroscopy later he discovered I had a hiatal hernia, which I had surgery for about a month ago. Previous doc didn't use fleuro.

If you go with the lower priced insurance, maybe you can use some $ for HSA or flex spend for out of pocket expenses.

Good luck!

Nicki

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I'm at the office now and the receptionist told me self pay is $250 per fill. For me that's cheaper than the monthly deductible for the PPO. Looks like I'll opt for the H M O if I need to. Thanks everyone!

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Don't forget to ask if they do floor or barium swallow & how much that might be, hopefully you wrote down all your questions that needed to be answered , do they take other Surgeons patients , like I said the 1 surgeon that wouldn't take me is 15 minutes away , so I drive a hr. away , that's ok because I really like my surgeon.

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Thinking of you sorting all of this out -- pat yourself on the back! You are showing up for YOU! And your girls. Way to go.

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Thinking of you sorting all of this out -- pat yourself on the back! You are showing up for YOU! And your girls. Way to go.

Thanks, I needed that today. Having an emotional road bump today and just getting through it. Happily, my band got adjusted and I got the teeny fill I wanted, so 48 hours of liquids means I can't medicate with food even if I wanted to. Lol. Small blessings.

Edited by JustWatchMe

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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