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Maybe I should not have surgery?



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I have not been able to respond lately. I have turned off my internet for right now. And I was unable to sign on with my phone. But I have great news. I got a cOo last night with authorization for surgery. It did not take the insurance 15 business days it took 3. The lower of prayer is good. Now o. The k yes about a surgery date this year. Waiting for doctors call now.

That's wonderful news! I'm so happy for you. Remember - this is yours. It is about you and your health, and no one can take it from you. Crossing my fingers for a quick surgery date!

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Well I will not know anything for sure until next week if my surgery can be scheduled in 2015. I got a letter yesterday from the marketplace stating it was time to start looking at plans to change to. I called them asking why I got this letter was I not able to get the same insurance plan that I am on already? They said I would get a letter from the insurance company explaining. Well I do not have time to wait for that letter. So I called my insurance company. I was told with great regret that platinum plans will not be offered to NC residents for 2016. They said we will be offered diff plans but not with low company's and out of pocket max. I asked them what happens to my authorization for surgery come Jan 1 st when I go on a new plan? The lady said my authorization is only good thru December 2015. January 1 I will start with a new policy so will have to go they the whole process again. She also stated out of pocket max will go up to 10 and 20 k. I was like Omg. Well I will talk to my doctors office next week and let them know. They are supposed to call me to set my date. My only answer now is prayer that 2015 has an opening. I am sure I am not the only one going thru a lot of road blocks. But with this last roadblock I have to come to terms with the fact that there is always a reason for things that happen. If It was meant for me to get my surgery God will find the way for me.

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Sorry for the auto corrections made by my phone.

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I hope this works out for you. You have struggled so hard to make this happen. Many Drs offices work extra hard these days to accommodate patients as all these insurance problems affect their ability to make a living as well as patients health.I am sure many of us here are waiting to hear the good news of your surgery date in Dec 2015.

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Thank you so very much. Everyone here has given me so many good thoughts. A lot to think about in life with or without the surgery. Although I have tried to put all that behind me until after surgery. But is something that will be dealt with either way.

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Good on you for being so proactive about your insurance coverage and making the surgery happen in 2015. Very, very impressive! :)

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VSGAnn2014. There is no guarantee I will be able to get on the schedule for 2015. I am praying that I can. But, if they have no room for me then my surgery dream is shattered and over. I can't go thru this again. It was an emotional roller coaster. I have learned a lot about people in my life and will have to move on at that point. I only found this new info on Friday. It just seems more and more keeps slamming the door in my face. If this slams the door also I will be done.

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There's this thing called "positive thinking."

Have you heard of it?

;)

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Of course I have thought positive thoughts thru the whole process and I am sure you know how stressful the process is. I'm losing hope at this point. You can only slam the door in someone's face so many times b4 the just give up or give in. If I did not have positive thoughts I would not have made it they the past 7 months of this process.

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.......then my surgery dream is shattered and over. I can't go thru this again. It was an emotional roller coaster.

So in other words .... if your surgery can't be by 12/31/2015, it's your own decision to not have it done.

Your dream is not "shattered and over". You are making the choice to not have the surgery if it can't be done by the exact date you want it done by. You are willing to spend the rest of your life obese because you want to cut your nose off to spite your face.

You are basically saying "If I have to wait x more months, I'd rather be obese forever". Has anyone ever spoken with you about your decision making skills?

Lots of people have a long approval process. Lots of people have delays. I had one litigation matter in its 5th or 6th year (not related to my surgery) that managed to postpone my surgery for a full year. It was delay after delay. I couldn't schedule until it settled or went to trial. I had no choice but to wait, but there was nothing that was going to keep me from my goal. It was what it was. Rather than waste my energy on something I couldn't control, i focused on what I could control. Was it sometimes frustrating? Sure, but you just keep going and moving ahead.

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Jeraycitygal, I am not giving up that easy. Nothing about this has been easy. But yes it is over if I can not get in this year. I have waited more then 10 years to have insurance that would cover this surgery. I actually started with a diff practice then my insurance didn't cover them any longer. So I changed to the practice that I am with now. I have done everything required and have my authorization. Then I get a letter to get ready to chose another insurance plan from the market place. I called and they directed me to the insurance company. My insurance company stated they will not be offering my policy next year and that no platinum plans will be offered. And so I asked what was going to happen with my approval. Well I was told it was no good for 2016 just as suspected. So no platinum plan means night deductibles and out of pocket max. Something I can not afford after living on one income for the past two years. The outbid pocket max is paid this year. I can not find anyway possible I can financially do it. So yes I will just have to stay fat. But I can possibly find a doctor to fix the hernia and gallbladder before the year is up. I am sure that I am not the only one that is in this position. And those that have the money to not give up your dream. I am super happy for you. But that is just not my case. But I do thank you for your constructive criticism trying to get me not to give up. But for me this was the last shot.

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It's really not the time being the problem. It is the financial situation and insurance situation.

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@@Jangy03253 Have you actually called the practice, told them about your situation and implored them to get you on the schedule? If they know what's going on and can see how badly you want this and motivated you are, they might be able to make it happen for you. If they don't understand why it has to be this year, they won't try as hard because they think it's just a preference, not an absolute necessity.

Edited by gpmed

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@ Gpmed yes I have on multiple occasions. Today I was told first come first serve. No exceptions. And I would not ask for them to put me in front of anyone else. I would just like a yes or no so that I would know if I need to find another doctor quickly to take out my gal bladder and fix hernia. But I am not getting that. I did get that there are some spots in December but I would have to wait my turn to find out if I can have one. I was even asked would I have bariatric coverage on my next policy. How will I know that until I am able to select one and if it has coverage then it does. But it still don't change that i can not afford the expense of it again ???? wish it was diff and didn't matter. But it is what it is. And I have to accept that. It's not that I gave up because I want to give up. I have gone as far as putting my truck up for sale this year to get what I needed for surgery and a diff vehicle in its place and well if u know any Texas girls you know that their trucks are the last things they give up. ????

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Wow yesterday and well the past week has been a major roller coaster for me. I have no support in NC and omg I almost slipped on a cig. But, have made sure I went to bed with great thoughts last night of not caring what happens either way. I can not let this bother me anymore because it made me physically ill yesterday. If this surgery is meant to happen it will. I am a strong believer that everything happens for a reason. I had to take the blinders off and realize there are so many roadblocks for me thru this and there has to be a reason for them all. So if I get a date this year who hoo. If I don't yes I will be sad and prob very emotional like I have been the past week. But I just need to remember there is a reason. Thanks for everyone's support and constructive criticism. I read it all and took it all in. ????

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