Laid-Off: Insurance may expire soon... - Page 2 - ThinnerTimes

Jeanie · 10-13-2005, 05:11 PM

Quote:

Originally Posted by bridgetgirl

If you have a PPO you dont need a referral or talk to anybody that to get a referral to anything.... with a PPO you can do it all yourself! No need to wait on anybody!

So are you going to look into the COBRA thing or what man? Talk to you soon!

Having a PPO does not guarantee coverage of the surgery. Yes you can see and talk to whom ever you want, but they can still say NO to the surgery. They might cover the hosital stay but not everything else. I just know that Cigna no longer covers it at my work for HMO, EPO, or PPO. That is why I said something. It would suck for you to go through the process just to be told Cigna doesn't cover it. Better to be safe than sorry!

JustWesWaiting2Lose · 10-13-2005, 05:14 PM

and I do appreciate you saying something about it Jeanie...other than following up with COBRA, any other suggestions?

eyesthatkissu · 10-13-2005, 06:26 PM

If you have a PPO and they exclude Gastric Bypass, you can still have the surgery under "elective procedures" in which case a percentage is covered. On my old PPO my first time around with WLS it was an 80/20 split.

Veruca Sault · 10-13-2005, 11:28 PM

Quote:

[color=DarkOrchid][font=Comic Sans MS][b]If you have a PPO and they exclude Gastric Bypass, you can still have the surgery under "elective procedures" in which case a percentage is covered. On my old PPO my first time around with WLS it was an 80/20 split.

Which with me woulda been 7K out of pocket = (

bridgetgirl · 10-14-2005, 10:00 AM

Every time you get "authorization" for a procedre they always have a disclosure that says "it is not a guarantee of coverage, it is not a promise to pay......" with insurance, nothing is 100% at least with PPO's and workers comp!

JustWesWaiting2Lose · 10-19-2005, 09:16 PM

Hi ladies and gentlemen...

Ok, let's see

Done: the EKG, the X-rays today.
Blood work, urinalysis...hmmm recently done from my last phsyical

To-Do: Pysh Eval - 10/20/05 1:30pm (tomorrow)
To-Do: Sleep Study Consult - 10/27/05 Study - 10/31/05
To-Do: EchoCardiogram - 11/04/05 7:30am
To-Do: Surgeon's Consultation - 11/04/05 2pm

...btw gonna do my utmost to go with COBRA. Found out that my insurance is till the end of the month (ok, a little more time).

Veruca Sault · 10-19-2005, 09:59 PM

Wes, since you can self refer why not call SDBariatrics? Thats Dr. muellers practice and to my knowledge you dont need a sleep study unless you are like BMI 35ish and no co morbidities.

Christina · 10-19-2005, 11:28 PM

Since you are Cobra now.. I am assuming.. you may want to get ahold of Dr. C's office and just let them know, so maybe they can expedite your surgery or auth request?? Lisa may help you out there knowing that you are putting out a lot of extra money now and it is a financial harship for you? Hey it's worth a shot right?

Good luck to you.

JustWesWaiting2Lose · 10-19-2005, 11:29 PM

But Veruca... can I do that even after starting if you would with Dr C?

JustWesWaiting2Lose · 10-19-2005, 11:31 PM

Thanks for the suggestion Christina, do you think I should do that even though my issurance hasn't ended yet?