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Insurance changing during Pre-op process (insurance specialists needed)



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Hey! Let's start from the beginning... I live in NYC. I started this process with straight Medicaid after my prior private insurance (UHC Commercial) expired on 07.31.2016. I still had straight Medicaid as a backup so it automatically became my primary insurance. My pre-op appointments started 08.01.16. Blood work was done the same day as the initial appointment. My nutrition appointment was 08.08.16. I received a letter stating that I had to enroll into an HMO plan by the 15th of August. I received this letter the 23rd...I called and asked what were my options and was told that I can send in an exemption form. I don't qualify for exemption because all of my providers take Medicaid HMO. So after hours of run around with Medicaid, HRA and the Marketplace I was told that I have no options available to keep my straight Medicaid and I will be enrolled into Empire BCBS on October 1st. They require 6 months supervised diet which straight Medicaid does not. So this process (including the psychological evaluation I just completed) would have to be started over. I'm just at a loss of what I can possibly do to resolve this! So here are my questions for you...

1. Can I submit my documents ASAP and get approved by October 1st and have the surgery with straight Medicaid?

2. Will the surgery date have to be before October 1st as well to go through straight Medicaid?

3. Is there another way I can keep straight Medicaid until after the procedure?

4. If I do ultimately have to change my insurance will they accept my initial nutritional appointment as the first month of the six month program?

5. Can I inquire about a tentative date of surgery to appeal an extension of straight Medicaid insurance?

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When does your medicaid term? And yes your bcbs will take your previous dictation since it was done within 6 months

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October 1st is when my insurance will change

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I would try asap to get the surgery before the 1st. That'll be on your surgeons office. I'd get on the ball. You don't want to wait! They won't let you continue coverage.

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I will try! Thank you

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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. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • 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.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
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