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

Switching Insurance Mid-Stream?



Recommended Posts

Hi all! I've recently gone to my first consultation with my PCP about the band and she's behind me all the way. She wrote me a referral to the nutritionist that I need to call on again (I called before to ask if there was a charge and I got voicemail and never got a call back) and wants me to do a few months sup. diet before trying for a referral to the surgeon.

My insurance sucks and will put up a big fight, I know this. I talked to another lady at the info session who has my same insurance and said you have to do 6 months diet first, then pursue an appt. with the surgeon, and they'll only cover it if it's life-threatening. Ok, so I know where I stand with insurance. This was night before last.

This afternoon, my boss hands me a sheet of paper with a questionnaire because our company is shopping for insurance! I'm kinda excited about this, but at the same time, kinda nervous! How are things affected switching insurance companies mid-stream into the pre-request process? Am I going to have to start all over again once we find out new plan? I'm expecting so, which makes me want to just wait on seeing the doc again on the regular right now cuz the co-pay sucks, but what if we don't end up changing companies? Then I'm gonna have to start all over anyway!

:help:

Share this post


Link to post
Share on other sites

You shouldn't have any problems - just make sure that your surgeon is in-network on the new plan and there's no WLS exclusion.

I switched my insurance plan right before I finished the pre-op testing because my original plan had an exclusion. My employer let me switch plans, they rock!!! I found a new plan that does cover it and my surgery is 8/27/07!!

Good luck.

(I had to do a 6 month diet for my new insurance - I knew about it in advance and started it right away)

Share this post


Link to post
Share on other sites

Well the part that complicates things is that I'm not telling my bosses I'm getting this done. They're not understanding like that. Nice, yes. Great bosses, yes. But not like this. So I can't just kinda nose around like... Oh hey I need to know ahead of time which plans you're looking at so I can compare them for my own benefit which I'm not going to tell you about, and then hope you go with the one I like! *add sicky sweet smile here*

Things would just be a lot easier if I could have them keep me in mind, but they would freak out. They're fit health nuts. *sigh*

Share this post


Link to post
Share on other sites

MY boyfriend says there's no use in telling my bosses about it because it's rather unrealistic to think they'll choose a plan based on my needs. I'm the only MO one at the whole company, so asking them to get a rider is just insane. Does anyone know if I could get a rider on my own if it was needed?

:bump:

Share this post


Link to post
Share on other sites

MY boyfriend says there's no use in telling my bosses about it because it's rather unrealistic to think they'll choose a plan based on my needs. I'm the only MO one at the whole company, so asking them to get a rider is just insane. Does anyone know if I could get a rider on my own if it was needed?

:bump:

Unless your company is a large one it's very unlikely they'll be purchasing "riders" for various conditions. Most small- and mid-size company plans are off-the-shelf products from carriers. So your boyfriend is probably right.

But there's no reason you can't make your preferences known. Very often employers count their employees' desires as an important part of the decision-making process. Is there a carrier your doctor likes over another one? Try to find that out, and then let your company know, for example, that XXX carrier is better for you just because more of your doctors are in the network (or some such reason). That's something I hear all the time from my clients -- no company wants to make their employees unhappy by switching to a carrier that none of them can use with their own doctors.

Share this post


Link to post
Share on other sites

I'm just afraid of bringing it up with my bosses... I don't want to get a lecture or that psuedo-helpful "advice" we've all gotten a zillion times. heh.

I took a snoop around the BC/BS website which we MAY go with, and it looks like they'll cover GB, but I don't want that... I wonder if it includes banding? Hmm.

Share this post


Link to post
Share on other sites

Wendy- I think you should tell your employer- you have an opportunity to make a change before they sign a contract. If you dont say anything, you run the risk of them not including the option of weighloss surgery. At least if you say something, your voice has been heard.

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

    • vsg.with.sharon

      Hey everyone!
      I’m new here! Looking for some friends! 🥰
      · 0 replies
      1. This update has no replies.
    • LeighaTR

      Four days post surgery. I am sipping as fast as I can and getting NO WHERE near the goal of 60 - 80 grams of protein or the 64 oz of liquids. I just feel FULL. I don't know if it can still be the gas build up (I would think by now that would be gone) but it is a struggle to drink. And so far I have not had the nausea or spasms and don't want to wander into that territory by pushing too hard with liquids. I about passed out today as it was my most "strenuous" day. Went from second story to basement for shower and I was sure I was going to pass out. Looking back on my last few days I have had a total of less than 1000 calories. Am I just not getting enough nourishment in me? Once again a friday where I can't get ahold of the doc until Monday rolls back around so I am hoping maybe someone here has some experience on how to keep energy going. I do have fibromyalgia too and that may be where some added fatigue comes into play. How did you all fair with the goals the week after surgery?
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      2 days until I fly out to San Diego to have my Bypass Surg. in Tiajuana Mexico. Not gonna lie, the nerves are starting to surface. I don't fear the surgery itself, or the fact that I'm traveling alone, but its the aftermath that I'm stressing about the most, after this 8 week wait. I'm excited to finally be here, but I am really dreading the post surgical chapter. I know its going to be tough, real tough and I think I'm just in my head to much now that the day i here. Wish me luck, Hopefully I'm one of the lucky ones, and everything goes smoothly. Cant wait to give an exciting update,. If there is anyone else have a June bypass or even a recent one, Id love to have someone to compare war stories with. Also, anyone near San Antonio Tx? See ya soon with the future me. 💜
      · 3 replies
      1. Phil Penn

        Good Luck this procedure is well worth it I am down to 249.6 lb please continue with the process..

      2. Selina333

        I'm in Houston so kind of near you and had the sleeve in Dec. Down 61 lbs. Feeling better. Was definitely worth it. I hope the everything is going well for you. Update us when you can!

      3. Doughgurl

        I am back home after my bypass surgery in Tiajuana. I'm post op day 4. Everything went great! I guess I'm one of the lucky ones who have not encountered much pain at all, no nausea thus far and I'm having no problem keeping down broths and water. Thank you for your well wishes. I cant wait to keep up this journey and have a chance at better health and simply better quality of life. I know there will be bumps in the road ahead, and everything won't be peaches and cream, but at least I have a great start so far. 😍

    • LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 2 replies
      1. Selina333

        I'm so happy for you! You are about to change your life. I was so glad to get the sleeve done in Dec. I didn't have feelings of regret overall. And I'm down almost 60 lbs. I do feel a little sad at restaurants. I can barely eat half a kid's meal. I get adults meals often because kid ones don't have the same offerings at times. Then I feel obligated to eat on that until it's gone and that can be days. So the restaurant thing isn't great for me. All the rest is fine by me! I love feeling full with very little. I do wish I could drink when eating. And will sip at the end. Just a strong habit to stop. But I'm working on it! You will do fine! Just keep focused on your desire to be different. Not better or worse. But different. I am happy both ways but my low back doesn't like me that heavy. So I listened (also my feet!). LOL! Update us on your journey! I'm not far from you. I'm in Houston. Good luck and I hope it all goes smoothly! Would love to see pics of the town you go to for this. I've never been there. Neat you will be traveling for this! Enjoy the journey. Take it one day at a time. Sometimes a few hours at a time. Follow all recommendations as best you can. 💗

      2. Doughgurl

        Thank you so much for your well wishes. I am hoping that everything goes easy for me as well. We don't eat out much as it is, so it wont be too bad in that department. Thankfully. Also, I hear you regarding your back and feet!! I'd like to add knees to the list. Killing me as we speak! I'm only 5' so the weight has to go. Too short to carry all this weight. Menopause really did a doosey on me. (😶lol) My daughter also lives in Houston. with her Husband and my 5 grand-littles. I grew up in Beaumont, so I know Houston well, I will be sure to keep in touch and update you on my journey. I may need some advice in the future, or just motivation. Thank You so much for reaching out, I was hoping to connect with someone in the community. I really appreciate it. 💜

  • 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

    ×