slap in the face - ThinnerTimes - Gastric Bypass Forum, Lap Band Forum, and Vertical Sleeve Gastrectomy Forum

MissKeaton · 10-20-2009, 05:02 PM

So today we had a benefit meeting at work. I was expecting increase in premiums on our health insurance. They are changing insurance companies as of January 1, 2010. Had already talked to Dr. Keith about having my surgery mid February, because that is the ONLY break i get in school until next December, and that was just a fluke because of classes being rotated. Switching from Anthem Blue Cross of California to Blue Shield of California. So I'm thinking great, that gives me a month and a half to get approved again, not gonna happen. So i go to break shaking and crying. I call the new company and the guy wont tell me anything but that the doctor has to call in and I cant call and get any info at all. Never tell me I cant do something, especially get info. So i called the number he gave me for the doctor to call and the lady told me that its basically what i had to have for anthem (physical, history, dietitian, psych eval) and then wait for aproval, and the doctor has to be accepted by blue cross blue shield in my area. She said that after they send everything in they should have an aproval or know if i need something else within 5 days. So as long as Dr. Keith will set in stone a day for me, i SHOULD be ok.... I hope. The only thing is, I wont know how much it will cost me out of pocket for sure until then. I will have to put it all on my flex card, so I get to just guestimate how much i'll need. So my max out of pocket a year is $2K so i'm gonna just have to put that on there plus whatever i think i'll use in supplements and vitamins and if there is left over i'll just stock up for the next year lol.

Sorry i needed to vent I feel like I've been slapped in the face, and I'm scared that it wont work out. Anyone else have Blue Shield of California?

poet_kelly · 10-20-2009, 05:53 PM

Ugh. That is stressful. I'm sorry you're having to deal with that. But at least it sounds like it should work out OK.

Just a note- if you can use your flex account to pay for vitamins, put a LOT in there. 'Cause vitamins are expensive! Can you use it to pay for protein powder, too?

Kelly

Okie Sunshine · 10-20-2009, 07:11 PM

Keaton,

So sorry to hear about your frustration. To be so close and to feel like you're having to start over must be a nightmare. But keep your chin up and keep moving through the paces and you'll get there. Keep us updated

Breanna

Diann · 10-20-2009, 07:39 PM

Sorry to hear about your insurance situation, I truly hope that it all resolves for you and that your plan continues. Diann

no_more_big_order · 10-20-2009, 07:49 PM

I am sorry you are going through the insurance wringer. I had a similar situation... My surgery was approved 10.5.09... then I learned we are going through some insurance changes.... My surgery was supposed to be early 2010... However, my surgeon's office ended up moving it up to November.... Just a thought... if it is an option... Good Luck!!!

Laureate · 10-20-2009, 08:02 PM

Keaton, I like the way you work -- not taking no for an answer.

We're changing insurance, too. My surgery is scheduled this Monday and I don't anticipate any delays. But in the back of my mind, I fear that if it is delayed, I'll be in trouble.

I don't even know if the new insurance covers WLS.

hollycerniglia · 10-20-2009, 08:18 PM

I'm so sorry to hear of your insurance change. I hope everything works out well for you.

MissKeaton · 10-20-2009, 09:41 PM

well thankfully my surgeon/hospital is a circle of excellence or something like that (its a different name for blue shield), so i know its an approved hospital. I'm just so worried, because i only have the 2 week window or i have to wait till next december. There is no way i can afford to do it this year, i dont have the hours saved or the money.

With a doctors note i can get supplements and vitamins from any provider with a receipt and use my flex spending plan. Thankfully the office has both there and take the flex card, sadly they only have one month supplies for everything, so kinda get a little skrewed on that. But for 2011 I'm going to save up and use my flex card, pay upfront for 3 month supplies, then get reimbursed since bariatric advantage and such arent on the list. I've checked with the IRS just to make sure. As long as its not meant to totally suppliment all food sources, and is because of a medical condition, it is allowed. I think for the first year i'll use the ones from the office, then i might venture and use some of the other recomended things. I just know how bad my luck is, and how badly my body can react to things that dont agree.

One way or another, I will start my new life with a new tool and get my but on that bench. I have lost 9 pounds since i started all this in august tho

Chrissie23 · 10-20-2009, 10:03 PM

Take a deep breath..... just think... no matter what, you ARE having this done. It's just the journey to get there that is suckin for you right now. I'm hoping things come easier for you, though, and that you get approved and a date with a sexy surgeon soon!!!