Change from Medicaid to employer plan=no surgery for me. Heartbroken.

[heatherlarae 12]

I have been on Medicaid for 5 years as a single mom in college and then 2 years as an AmeriCorps VISTA. was referred for the sleeve in December by my family dr. Medicaid approved. Started a new job in February, insurance starts 4/27. Medicaid ends 4/30. Obesity surgery is excluded with my new coverage and I was so close! I can’t stop crying.

A friend suggested I contact HR. Does anyone have any suggestions what I should say?

[Sosewsue61 3,185]

Criteria for surgery, do you have comorbidities? Are there exceptions or just flat out refusal to cover bariatrics at all? Changing jobs sounds drastic but sometimes you have to make those decisions.

[Frustr8 7,886]

Wish you could be scheduled for SURGERY before that ends. There has got to be a way through this, wish you could go through as a special exemption case, or that you could pick up employment insurance at the end of May instead of April and your surgeon could complete it in that time frame. We did have some people on BP that are have worked Or are working in the insurance sector. Wussy they would chime in and give you some direction.😁

[heatherlarae 12]

Criteria for surgery, do you have comorbidities? Are there exceptions or just flat out refusal to cover bariatrics at all? Changing jobs sounds drastic but sometimes you have to make those decisions.

I do have comorbidities but the benefits manual lists obesity surgery as an excluded service. I’m determined to figure something out. But I love my job, just not happy about this.

[heatherlarae 12]

Wish you could be scheduled for SURGERY before that ends. There has got to be a way through this, wish you could go through as a special exemption case, or that you could pick up employment insurance at the end of May instead of April and your surgeon could complete it in that time frame. We did have some people on BP that are have worked Or are working in the insurance sector. Wussy they would chime in and give you some direction.[emoji16]

I have a friend who works in health care coming over tomorrow to look over my fiancé’s coverage. I may go to the courthouse and get married this week. Pushing my employers coverage back wouldn’t extend my Medicaid eligibility though. My new income is outside the limits. Thanks for your encouragement.

[Frustr8 7,886]

No poblem, does your fiance come with insurance, maybe,you could get absorbed,into his plan as his wife? Horrid thought: "honey I love you a lot but could. we get married a little sooner for insurance purposes?" Ain't life just peachy keen?😋

[Creekimp13 5,841]

Damn the bad luck. Sorry:(

[heatherlarae 12]

No poblem, does your fiance come with insurance, maybe,you could get absorbed,into his plan as his wife? Horrid thought: "honey I love you a lot but could. we get married a little sooner for insurance purposes?" Ain't life just peachy keen?[emoji39]

Yes, BCBS. And we have been engaged for 9 1/2 years, so it’s probably time.

[heatherlarae 12]

I have an update. Got my letter today from
JFS and I qualify for transitional Medicaid for at least 3 more months! As long as I can carry the same provider, I should be good to go! I may have been all worked up over nothing! (Hopefully).

[Frustr8 7,886]

Glory glory hallelujah, I knew there would be an answer and it turns out its a good one! You have my permission to still get married whenever you and BF want to. But forward unto surgery, when do you think you'll be ready to do that? You have worked so very very hard for this moment! Go for it Darling, go for it! Hugs and a Big Smile😝

[heatherlarae 12]

Glory glory hallelujah, I knew there would be an answer and it turns out its a good one! You have my permission to still get married whenever you and BF want to. But forward unto surgery, when do you think you'll be ready to do that? You have worked so very very hard for this moment! Go for it Darling, go for it! Hugs and a Big Smile[emoji13]

Thank you so much! My next appt is May 1, then approval and schedule the date. So hopefully before Memorial Day weekend.

[newmebithebypass 713]

huzzah life works its self out in its own time. there is a randomness to this universe of ours but in all of that a grand over arching purpose that works its self out in the end