insurance frustration

[KimA-GA 540]

sigh.. I should not complain, but yep I am…

I am in limbo and cannot get a date for surgery yet because I have two insurances; one that does not cover bariatric a at all and one that does. I just had to get my denial letter to the surgeon because they can’t seem to get a copy. Now it’s time to wait for approval in round two (the one with coverage).

My surgeon had October 5/6 as surgery in the first request but with the (what should have been expected) delay it could be the end of october or november … It just is less than ideal timing for my work and everything else (tho being on alternative diet for holidays doesn’t bother me so far, because i will eat different no matter what happens).

Maybe I am just being impatient and standing under a little black rain cloud of my own making … but the frustration is real to me!

anyone else experienced similar?

[summerseeker 1,844]

Oh yes but not via insurance. I had to pay for my surgery in a private hospital as everywhere in the UK was swamped with Covid cases and all surgeries were put back and non essential surgery was stopped altogether.

The hospital had its bariatric services audited and the surgeon then had a holiday which all put my surgery back at least 2 months. For a few weeks I felt like I was unjustly punished, the ' why me ' syndrome kicked in. I was so upset. Then I got over it, what else can you do ? The days dragged by and then I was into the 3 week pre op diet so they dragged even more but I got there in the end.

If your part of the world is into winter when you have the surgery, be ready, You may feel really cold, I did. Even in the house I needed lots of layers.

I hope you get it sorted soon

[KimA-GA 540]

43 minutes ago, summerseeker said:

If your part of the world is into winter when you have the surgery, be ready, You may feel really cold, I did. Even in the house I needed lots of layers.

I hope you get it sorted soon

oh, my! that must have been very very frustrating! you are right, there is nothing that can be done but go with the flow as best as you can.

we are technically going into fall, but here that doesn’t mean much. it’s still around 85F/29C … A tv station posted on Facebook this morning that it’s 100 days till christmas and the average afternoon temperature for christmas is 55f/12C …. tho we do have about a month it gets chilly in january

I am impatiently waiting for things to fall into place. Done all I can, now it’s up to everyone else !

[FireWife81 10]

Why was paperwork submitted to insurance that doesn't cover bariatric surgery?

I have two insurances as well. Primary covers bariatric surgery but secondary doesn't. My doctor's office said that they won't even submit bariatric procedure to secondary, only procedures and office visits that can fall under other parameters.

[KimA-GA 540]

since my secondary insurance knows it’s not primary, they had to show what the primary would pay (zero) before the second would pre authorize anything (only secondary has coverage)

[FireWife81 10]

On 9/16/2022 at 8:11 AM, KimA-GA said:

since my secondary insurance knows it’s not primary, they had to show what the primary would pay (zero) before the second would pre authorize anything (only secondary has coverage)

That bites

[ShoppGirl 3,354]

Ahhh the insurance hurdle blues. At least you know that they will cover eventually though. Try to focus on that. I believe they only have 30 days to approve or deny so it shouldn’t be much longer.

[lussa 21]

I can sort of relate, though it has less to do with my insurance and more with the surgeon’s office/hospital. So busy. Called in March 2021, finally got in May 2021, and just now getting the surgery this coming October 2022 after all the required appointments and many delays. I was hoping to get it last fall so it’s been a year and a half in the making. Very curious as to how this holiday season will go because it’ll certainly be different…