http://www.thinnertimesforum.com/ Discuss insurance topics for the gastric bypass and Lap BandŽ operations. en Fri, 20 Nov 2009 22:22:54 GMT vBulletin 60 http://www.thinnertimesforum.com/images/misc/rss.jpg http://www.thinnertimesforum.com/ http://www.thinnertimesforum.com/insurance/40705-medicare.html Thu, 19 Nov 2009 15:44:04 GMT ne one have medicare? ne one have medicare? ]]> Insurance RetroNails http://www.thinnertimesforum.com/insurance/40705-medicare.html http://www.thinnertimesforum.com/insurance/40639-highmark-bcbs.html Tue, 17 Nov 2009 18:01:21 GMT Does anyone on here have Highmark BCBS? Just wondering how hard it is to get approved? I'm getting different answers from the Dr. vs. the Dr's secretary vs. the insurance company and not sure who to believe. I'm so confused. Can anyone shed some light from their experience? ]]> Insurance askopec http://www.thinnertimesforum.com/insurance/40639-highmark-bcbs.html http://www.thinnertimesforum.com/insurance/40592-federal-bcbs.html Mon, 16 Nov 2009 02:58:33 GMT I am only one appt. from submitting to insurance for approval. I am wondering if anyone had any difficulty with getting approval from Federal BCBS? Just curious...thanks!:confused: I am only one appt. from submitting to insurance for approval. I am wondering if anyone had any difficulty with getting approval from Federal BCBS? Just curious...thanks!:confused: ]]> Insurance buckus611 http://www.thinnertimesforum.com/insurance/40592-federal-bcbs.html http://www.thinnertimesforum.com/insurance/40552-aetna-insurance-question.html Sat, 14 Nov 2009 14:26:27 GMT I am in a 3 month program for weight loss giving by the hospital and required my Aetna PPO insurance. My surgeon's office said that I need to call at the end of November for my surgery date (the surgery for my gastric bypass should be at the end of January) but they will not be sending all my information to Aetna till the end of December.:confused:

My question is: How can they give me a date for surgery without getting approval from Aetna first? I will call the office on Monday but was just wondering if there were anyone else out there with Aetna? ]]> Insurance Jodi http://www.thinnertimesforum.com/insurance/40552-aetna-insurance-question.html http://www.thinnertimesforum.com/insurance/40548-pacificare-vs-blue-cross-vs-kaiser.html Sat, 14 Nov 2009 07:07:51 GMT So I currently have Blue Cross. I've just started the process but still sort of upset my insurance will probably be changing. If I had a choice which offers more coverage and is a better program. My doctor said Kaiser is great. Can anyone attest to that?

Thanks! ]]> Insurance girlieinsd http://www.thinnertimesforum.com/insurance/40548-pacificare-vs-blue-cross-vs-kaiser.html http://www.thinnertimesforum.com/insurance/40536-switching-insurance-plans-b4-surgery-date-help.html Fri, 13 Nov 2009 21:43:55 GMT I have been on my parents private insurance plan and got my approval yesterday! They scheduled my surgery Dec 7th the day after my 25 birthday which puts me off their plan! If I get my own plan now will I have to start over? I'm getting the same exact plan as what I am on now just under my name not there's. Anyone know anything? Please help me I'm in panic mode now!!!! ]]> Insurance Meg_pie http://www.thinnertimesforum.com/insurance/40536-switching-insurance-plans-b4-surgery-date-help.html http://www.thinnertimesforum.com/insurance/40531-hospital-costs.html Fri, 13 Nov 2009 18:21:02 GMT Don't know if anyone has any clue about this but thought I would ask.

I have an HMO and the surgery is zero cost to me as well as anestesia but he only cost is I am responsible for 30% of hospitalization.What's 3 days and two nights usually cost?

I sold a horse in August of 08 and I am still holding onto that money! lol oh and my max out of pocket is $3500.00 so I know it won't be more than that. But if i am right, if the bill is $5000.00 I am paying $1500.00??? ]]> Insurance Melissah http://www.thinnertimesforum.com/insurance/40531-hospital-costs.html http://www.thinnertimesforum.com/insurance/40524-open-enrollment-right-now.html Fri, 13 Nov 2009 14:33:11 GMT SO, I am wondering. My surgery is scheduled for Dec 7. My insurance runs jan to jan. I got my insurance through work for myself even though I also have insurance through my husband. His insurance doesnt cover my surgery but mine did. Now it is open enrollment. I am wondering if I... SO, I am wondering. My surgery is scheduled for Dec 7. My insurance runs jan to jan.

I got my insurance through work for myself even though I also have insurance through my husband. His insurance doesnt cover my surgery but mine did.

Now it is open enrollment. I am wondering if I should not get the health insurance through my employer and just use my husbands. I pay $100 a month for mine. It is pretty crappy insurance and getting worse next year. HOWEVER, it did cover my surgery. (I have spent about $5000 for it by the time I met my deductible and co-pays plus about $1200 in premiums...so about $6200 if you count the premiums.)

Do you think husband's insurance would cover me if I had any complications or issues after my surgery? I have not used his insurance at all to cover anything...like not listed it as a secondary insurance or whatever.

Also, I can sign up for short term or long term disability now. Should I do that? I didnt do it this year because it was expensive. BUT, should I do it now with the money I would save if i canceled my health insurance? Just in case any complications come up where i need to be off work for a while (like my liver cracks or i get pneumonia or a stricture or obstruction or whatever other complications that could keep me from working for any amount of time. Will the short/long term insurance cover me if they were not in effect when i had my surgery?

Anyone know what I should do? ]]> Insurance FatButNotHappy http://www.thinnertimesforum.com/insurance/40524-open-enrollment-right-now.html http://www.thinnertimesforum.com/insurance/40520-insurance-coverage-vertical-sleeve.html Fri, 13 Nov 2009 13:19:49 GMT Has anyone on this forum ever had Medicare cover the Vertical Sleeve? Thanks, Tammy Has anyone on this forum ever had Medicare cover the Vertical Sleeve?

Thanks,
Tammy ]]> Insurance tamtrch http://www.thinnertimesforum.com/insurance/40520-insurance-coverage-vertical-sleeve.html http://www.thinnertimesforum.com/insurance/40466-i-am-approved.html Wed, 11 Nov 2009 17:41:53 GMT I just have to shout it from the rooftops. I am on top of the world! I AM APPROVED!!! Its taken almost a year from the time I first decided I wanted to get lapband surgery to jump through all the hoops and had to go as far as doing two appeals with Aetna (because my 2007 weight was too low).... I just have to shout it from the rooftops. I am on top of the world!

I AM APPROVED!!!

Its taken almost a year from the time I first decided I wanted to get lapband surgery to jump through all the hoops and had to go as far as doing two appeals with Aetna (because my 2007 weight was too low). But, it was all worth it. I'm on my way!!! ]]> Insurance adagirl http://www.thinnertimesforum.com/insurance/40466-i-am-approved.html http://www.thinnertimesforum.com/insurance/40398-dedutible.html Mon, 09 Nov 2009 22:15:16 GMT I have a 500.00 dedutible that I met already this year. I been approved to have surgery, but I have some sessions I have to complete before I can get a surgery date. Now it's the end of the year and I'm hoping to atleast get a date in Dec. If for whatever reason I get schedule for Jan, will I have to pay another dedutible eventhouggI'm approved already? I think common sense tells me yes, but I'm hoping NO!!! lol ]]> Insurance wow http://www.thinnertimesforum.com/insurance/40398-dedutible.html http://www.thinnertimesforum.com/insurance/40383-rumors-about-medicare-sleeve-help-plz.html Mon, 09 Nov 2009 17:29:24 GMT Hi, I have been begging for help all over the WLS boards on this one. I read on another board last week that Medicare is covering the sleeve in January 2010. I am scheduled to do a self-pay on Dec 2nd. So this new information has thrown me into a bind. Should I postpone my operation? Does... Hi, I have been begging for help all over the WLS boards on this one. I read on another board last week that Medicare is covering the sleeve in January 2010. I am scheduled to do a self-pay on Dec 2nd. So this new information has thrown me into a bind. Should I postpone my operation? Does anyone know how I can get any more info on this? Is there a Medicare dept. or person that could give me more information than the 1-800 number or the website?

Thank you so much for your time! ]]> Insurance Lilac_Cat http://www.thinnertimesforum.com/insurance/40383-rumors-about-medicare-sleeve-help-plz.html http://www.thinnertimesforum.com/insurance/40339-my-bills-starting-come-united-healthcare.html Sat, 07 Nov 2009 15:33:01 GMT Here is an excerpt from my blog - regarding my charges for the RNY on 10/22/2009. I am a lifelong conservative and Republican, but the complete disconnect we have here in the United States of America regarding health care is driving me nuts. Image: http://www.conundrumcomputing.com/photos/Chris2... Here is an excerpt from my blog - regarding my charges for the RNY on 10/22/2009. I am a lifelong conservative and Republican, but the complete disconnect we have here in the United States of America regarding health care is driving me nuts.

My son, Christopher, died in May 2004 and was multi-handicapped. Most of his 20-year-life was spent by me working for one company - not becuase I was completely satisfied there, bbut because I was terrified of 1) not having health insurance or 2) pre-existing conditions should I take a new job.

To me it just doesn't seem right that we are the most prosperous nation on this planet, but we do not provide basic services to our citizens. I know this may be unpopular with my conservative friends, and my own brother just commented on facebook, to my mother, "do you know a Stephen Jones?" after I posted similar comments there.... but we have to find a way to make this right.

anyway, here is the bills and adjustments and settlements so far.

I got the hospital bill for my gastric bypass surgery yesterday. This is just the hospital bill and does not include any inevitable discounts that the insurance company will apply to the final settlement. I had my surgery at the NE Georgia Medical Center in Gainesville, GA, by Dr. Robert Richard of Obesity Solutions. I was very impressed with the hospital, and with Dr. Richard as well. In the documentation I reviewed, they cover expected costs for this surgery if it is "self-paid", meaning no insurance benefits are available.

the estimates were
$15,500 facility fee (Hospital)
1,200 anesthesiologist
8,000 Surgeon
700 Surgical Assistant
---------------------------------
$25,400 total estimate

I have just rec'd the Explanation of Benefits for the hospital. Here is what they billed

$ 1,312.00 Room/Board (2 full days, 2 nights)
4,642.57 Pharmacy
27,547.12 Supplies
1,360.00 Lab
1,276.38 Radiology
231.78 Cardiology
16,928.97 O.R. Services
46.45 Professional
----------------------------------------------
$53,346.19 total patient charges

The insurance company, United Healthcare, applied a "net discount" of -$39,922.04 to the hospital bill, leaving a net of $13,377.70 for the Hospital portion of the procedure.

Dr. Richard charged $9,225.00 for his services, the Surgical Assistant charged $2,244.00. Those charges are "under review" by United Healthcare.

More to come! If you'd like to read more, visit my blog (see link in my sig line) ]]> Insurance DrStephen http://www.thinnertimesforum.com/insurance/40339-my-bills-starting-come-united-healthcare.html http://www.thinnertimesforum.com/insurance/40302-anyone-have-health-net-hmo-greater-tri-city-ipa.html Fri, 06 Nov 2009 00:54:28 GMT Hello I was just wondering if anyone has had any experience with Health Net hmo and the medical group Greater Tri-City IPA. I just had to change medical groups and now I have them. Thanks Hello I was just wondering if anyone has had any experience with Health Net hmo and the medical group Greater Tri-City IPA. I just had to change medical groups and now I have them. Thanks ]]> Insurance Cynthia http://www.thinnertimesforum.com/insurance/40302-anyone-have-health-net-hmo-greater-tri-city-ipa.html http://www.thinnertimesforum.com/insurance/40290-bcbs-approval.html Thu, 05 Nov 2009 20:27:46 GMT Those of you with BCBS, how long did it take for you to get approved? Those of you with BCBS, how long did it take for you to get approved? ]]> Insurance krbunch http://www.thinnertimesforum.com/insurance/40290-bcbs-approval.html