Princess J

Check out this article I ran into it today while researching a totally different topic. Funny how that works.
Anyway, check it out, it is about employers chosing not to pay for GBS.

__________________
Julianna L. Duryée
Open RNY 7/29/03 Dr. Callery
286.5/137/150
Email Me!
See My WLS Story Online

bridgetgirl

I Say We Boycott Cingular And Walmart! What Do You Say About Those Apples?!

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J.Bridget Fisher aka koi-pea
2/9/04 lap 5'11"
298/170-trying to lose another 10

www.myspace.com/caliclovercutie
What Sawyer would call me on LOST: ladybug

"People will argue with you that getting what you want in life isn’t something you can learn, if you’re destined to be one of the worlds winners as opposed to one of its perpetual whiners, its because you have been born with the right talents and temperament and have a big dose of self-esteem, ambition, and good judgment." Kate White

pluto044

This has been my problem. My husband's insurance says they will cover, but the company that he works for will not let them because of the contract. Does that make any sense or is there something I can do to fight this.

I am 44 years old and weigh over 400 pounds. I am a severe diabetic that does not have any complications at this time. I'd like to keep it that way.

My doctor wants me to have the surgery, but I can't afford to do it on my own. What do I do now?

watergirl

It sounds like an employer problem and not an insurance issue. Is change of employment a possibility? Obviously not Wal-Mart or Cingular!

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Kim
On the road of life, it's not where you go, gut who's by your side that makes the difference.

Wherever you go....there you are.

Wrinkles only go where the smiles have been. - Jimmy Buffett

Lap RNY 8.9.04
266/130
Start BMI 41.6
Current BMI 19.9 I'm finally NORMAL! No longer Morbidly Obese, Obese or Overweight!

Myspace: My URL
http://www.myspace.com/h2o_woman

Christina

Julianna,

Thanks for the info.. I personally don't need it now, but I know there are plenty that do.. you are a wealth of information.. How are you doing??? I miss you girl.

Hope all is well..

__________________
Christina
Open RNY 03/31/2004
274/128/137 (131 Per Dr. C)
BMI: 47 / 22

"There's nothing noble in being superior to your fellow men. True nobility is being superior to your former self." - Ernest Miller Hemingway

"Obstacles are those frightful things you see when you take your eyes off your goal." - Henry Ford

bridgetgirl

Call your insurance company directly and ask if you have this covered benefit. When the surgeon requests to do the surgery they preautorize through the carrier, not the employer. Call them and see what they say... you may want to call Dr. C's office first and ask for the biller and get a procedure code for the surgery. That why the can do an accurate check for ya. Good luck!

__________________
J.Bridget Fisher aka koi-pea
2/9/04 lap 5'11"
298/170-trying to lose another 10

www.myspace.com/caliclovercutie
What Sawyer would call me on LOST: ladybug

"People will argue with you that getting what you want in life isn’t something you can learn, if you’re destined to be one of the worlds winners as opposed to one of its perpetual whiners, its because you have been born with the right talents and temperament and have a big dose of self-esteem, ambition, and good judgment." Kate White

nittinnana

Hi--I do medical billing for a living and even though the insurance may cover the procedure it can be denied if your insurance is self administered and they then decide what they will cover (self administered is where the employer pays all the bills but the insurance administrates the policy). I have BCBS but my employer self administates but they do cover the procedure so I am lucky. In the long run the surgery would be the cheaper route for them considering the medical problems with the overweight but sometimes employers look at today's bottom line and not the welfare of their employee.

princesse

How the hel can they justify $40,000 for a surgery??? Here in Europe, I *know* for at fact it costs ca $12,000 (Belgium)- $16,000 (Denmark) fro the surgery. That includes everythng, also all the post-op stuff....I wonder sometimes if it's not just a HUGE money making venture in America...
Nancy

__________________
Life is too short to dance with fat chicks...

Highest: 170+kg/375+lbs

Pre-op: Nov 2006
Weight: 165kg/364 lbs
BMI: Nov 2006: 61

Surgery: Feb. 2007
Weight: 143kg/315.2
BMI: Feb. 2007: 53.1

June 2008:
Weight: 83.2kg/183.4lbs
BMI: 30.6

Since Nov. 2006: -81.8kg/180.3 lbs.
Since Feb. 2007: -58.8kg/129.6 lbs.

'thann

My brother is director of underwriting for a large insurance company. His sole job is to work with companies to DECREASE what they cover. I expect that down the road, with the economy the way it is, many companies will opt to exclude WLS from their benefit plans. Just my gut feeling.

It's sad because the long-term health benefits eventually surpass the cost of WLS.

'thann

__________________
Lap RNY: 04/29/2008
280 | 250 | 199 [ONEderland finally!] | 130
Highest | Day of surgery | Now| My goal

frances

This is the part that I don't understand in all of this. MOST insurance companies, if not all, contract with providers to have them provide care for their members. Having said that, they contract with hospitals for differenc=t services at different rates. When I had my $78,000 surgery, the insurance company I had at the time was contracted with the hospital to pay a flat fee of $1500.00 per day and contracted with the physicians for a reduced rate as well. If memory serves, the total that my insurance company paid for hospital and physician fees was roughly $6000.00 - so it isn't costing the insurance companies as much as they are being billed.

I don't understand why more employers arent covering it. With contractual agreements they will be paying FAR less in the long run.

I don't get it.

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'Birthday' 8-28-03