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insurance changed - now what???



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I had my band 2 years ago -and my insurance covered it - we have since changed insurances and now my new insurance says it will cover nothing that has anything to do with wls or complications from it - I guess my worry it now what happens if I should ever have any complications and require more surgery or band removal? I really don't have enough money to cover thousands of dollars if I would need emergency surgery or even something small like a port revision - should this be a consideration for everyone who is getting the band - even when it is covered by insurance - that one day your insurance may change and anything arising from the band would not be covered? I guess I had never considered this - and wanted to be sure that everyone else does - I mean I knew I would have to pay for fills and such - but never considered the possibility that I may have to pay for a revision surgery. I don't as of now - and hopefully never would -but I have thought and worried about it.

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I'm sorry I don't have an answer for you but this really concerns me. I'm not scheduled yet for surgery and now i'm re-thinking it because of this.

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That is what happened to me too. I had surgery 4 years ago and 3 months after banded, my company changed insurance carriers. I have not been covered in 2 years. My surgeon retired in that time and I started having problems a month ago. No surgeon wanted to see me b/c I was banded by another dr. After 7 dr.'s turning me down and almost having a nervous breakdown, my hubby found a dr that would see. Well since my insurance does not cover wls it cost me $350 that we did not have and had to borrow from my mom. I will have to pay $150 for every follow up but now I am not sure about surgery. They told me yesterday that my band slipped. I was unfilled and put on the post op diet for the next 4 weeks and then I see my new dr again. He is hoping my band will slip back in place but if not he said he will have to go back in. If he has to go back in, I have no clue how we will pay for it! Sorry I do not have better news for you.

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You need to ask you current health insurance carrier or broker ( your HR rep may not know about this form) for a Continuity of Care form. You will then have to get the form filled out by your weight loss doctor. This form allows you (regardless of WL exclusions) to continue to receive care any condition or procedure which you were approved for by your prior health insurance carrier. I know this to be a fact, as I help my clients with this quite often. I am a health insurance broker.

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Hope this helps :eek:

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This is an interesting discussion. I'm glad to know about the 'continuity of care' option. I also think its a good idea w/any surgery like this (where ongoing coverage is not guaranteed) to start putting away money now for any future needs. Pretty much with anything implanted into your body, you may need revision surgery later or want it just because technology keeps moving and there may be better options in the future. Most women who get breast implants eventually need to get them replaced at least once (some twice) in a lifetime so it makes sense that w/the band (or any implanted device), you should plan that it might need to be replaced/modified at some point (especially if you are getting it young).

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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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