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A glimmer of hope

It seems that my surgeon's office has confidence that if I were to change insurance carriers there'd be an excellent chance of approval for a new band to replace the one removed in April. So I'm going to change effective July 1 (assuming I can talk my bosses into it, which I think I can). I was thinking about doing it anyway, since my docs are dropping out of my current network in August and with an HMO I have no out-of-network benefits. So today I'm going to be talking with my bosses about making the switch.

(Turns out there is one very good thing about being an insurance broker!! I believe in karma, and though I don't love this career I took on in 2000, if I'd done anything else I'm 100% sure I'd still be morbidly obese. In 2003 I was able to take the appeal process to the end because of my inside knowledge of the system, and since then this will be the second time I've changed carriers to follow my doctors.)

Thanks for all your support, and I'll definitely keep y'all updated!! :clap2:

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Hi Alex, That is good news. You really need this new band, it is not negotiable. I feel sorry for you all in America re the insurance situation. Here I just pay my annual premium, and I paid my surgeon $3,500 (his once off fee) and that is it. I am covered for life for fills, and any and all possible revisional surgery/replacement of the band etc, no questions asked.

Good luck with it, and work the system.:) Susannah

Great news! Looking forward to hearing your progress on this new angle. And I'm sure we will also learn some things about dealing with insurance companies.

Good Luck Alexandra! You are such an inspiration!

shelli

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This morning I told my bosses that I really want to switch to Horizon...the conversation has begun! I'm confident that it will happen effective 7/1, and then we start the request for precert all over again.

Now I just have to get through the next month or two without GAINING!!!

Good job finding other paths to get to your desired goal--good luck! July looks like your lucky month. Karen

I will be praying for you and keep us all posted. You are a real trooper and seeing how you push through things encourages me when I begin to fatler in my thinking. Thank you and good luck to ya!!!!

  • Author

Thanks, y'all!! I've talked to my bosses and it seems a sure thing that I'll be changing carriers in July. So I called my surgeon's office to let them know, and to see if I can get on the schedule for sometime this summer. My NEW tentative surgery date is...August 13! This is exactly one week shy of four years from my original band placement.

Now the next hurdle is, once again, insurance approval. First I have to do the paperwork to change carriers, get it approved and get ID numbers, then have my doctor submit the request for precertification. Whew!

August will be here before you know it--especially with all you have to do before then. Congrats on new possibilities--it looks like much more than a glimmer of hope now. Good luck! Karen

Alexandra,

I too lost my band due to slippage. I have been contemplating being re-banded next month but I do not know if I should be looking into a different band than the one I had originally. Should this be a concern, or should i just let the surgeon do his thing? I am trying to make sure this does not happen again, and if there is anything I need to research before I do it, I am ready to make informed decisions! Have you had to reconsider a different band? If anyone knows about being re-banded, I would love to hear your comments!

P.S. I have re-gained 20 pounds after the band was removed.......:)

Thanks to all! :)

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