Readytobeme

More Insurance Woes

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I got a call from my surgeons office today. Seems they called insurance to get pre approval for some of my tests. They were told that my plan terminated on Dec 31, 2017.

Long story short, our insurance through my husbands employer changed to UHC as of January 1, 2018 We just got the new cards and information in the mail today and knew nothing about it prior.

The worst part is that the surgery will cost me about 4 x more with this insurance than with our previous insurance. I don't think that I am going to be able to afford it. Been racking my brains out since I found out trying to figure a way. :(

2018 is not starting out well for me so far. Not sure why I expected anything different really.

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Oh no, what bad news! I hope you can figure something out. That must have been awful to hear.

While you're doing some thinking, the two options of either going to Mexico for surgery, or saving some money and paying a higher amount are both on the table. In the long run, you can expect to save quite a lot of money by having the surgery (less food and drink, less medicine and other health care expenses), so it's not like you're throwing money away. 

Sneaky changes in insurance policies - not fun.

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6 minutes ago, Jen581791 said:

Oh no, what bad news! I hope you can figure something out. That must have been awful to hear.

While you're doing some thinking, the two options of either going to Mexico for surgery, or saving some money and paying a higher amount are both on the table. In the long run, you can expect to save quite a lot of money by having the surgery (less food and drink, less medicine and other health care expenses), so it's not like you're throwing money away. 

Sneaky changes in insurance policies - not fun.

Thank you! It really did throw me for a loop. I have been upset about it all day. I will figure something out. I just have to.

The girl at my surgeons office told me to be glad that they cover WLS at all.

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57 minutes ago, Readytobeme said:

Thank you! It really did throw me for a loop. I have been upset about it all day. I will figure something out. I just have to.

The girl at my surgeons office told me to be glad that they cover WLS at all.

I want to fight the person who told you to be glad. 

I want to second @Jen581791‘s suggestion of traveling to Mexico. Both of us had surgery in Mexico and had positive experiences. I did a lot of research before choosing my doctor and would be happy to share that information with you. 

Don’t give up! WLS is worth its weight in gold. 

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I'm so sorry! That had to be frustrating/scary/disappointing. I know you will find a way, but roadblocks really stink.

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My surgery was delayed by 2 years because of stupid insurance problems. During that time I seriously considered (and researched heavily) having mine done in Mexico as well. My situation changed unexpectedly and I ended up having it done stateside. But I highly encourage you to ask Jen and Nerdy about it if there's any chance at all you could do it. I'm only 2 months out right now, but I am SO happy. Life is so much better for me now than a year ago. 

Whether saving up, or going to MX, this is something worth fighting for.

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19 hours ago, NerdyToothpick said:

I want to fight the person who told you to be glad. 

I want to second @Jen581791‘s suggestion of traveling to Mexico. Both of us had surgery in Mexico and had positive experiences. I did a lot of research before choosing my doctor and would be happy to share that information with you. 

Don’t give up! WLS is worth its weight in gold. 

Ha, ha! I may not have worded that right. Amanda is her name. She was just emphasizing that the fact they do cover it is the biggest hurdle and that the rest will fall into place. She is super nice person.

I appreciate the suggestions and support from you guys. I will not give up on this. I will have this surgery one way or another. I have come too far and my weight is having an effect on my health already. I must do it sooner than later.

I just had to go to my sleep Dr today. My bipap machine is set at a fairly high pressure and barely controlling my apnea. I am so ready to start feeling better.

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19 hours ago, Gretta said:

I'm so sorry! That had to be frustrating/scary/disappointing. I know you will find a way, but roadblocks really stink.

Good to see you, Gretta! I had been wondering if all was well with you.

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1 hour ago, Readytobeme said:

I just had to go to my sleep Dr today. My bipap machine is set at a fairly high pressure and barely controlling my apnea. I am so ready to start feeling better.

That's part of what pushed me over the edge as well. Type 2 diabetes was the first thing, about 8 years ago. I didn't control it well at all the first few years, and only marginally after that. So there's one and sometimes two drugs. Then came high blood pressure. Another pill. Then high cholesterol. Another pill. Then sleep apnea. Awesome now I have a whole freaking CPAP machine to keep up with.  And a monthly co-pay for it. Right toward the end I really just felt like I was drowning in it all.

Now I'm on nothing. CPAP is packed up. 

I'm glad you have a determination to see it through somehow. 

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49 minutes ago, Michael_A said:

That's part of what pushed me over the edge as well. Type 2 diabetes was the first thing, about 8 years ago. I didn't control it well at all the first few years, and only marginally after that. So there's one and sometimes two drugs. Then came high blood pressure. Another pill. Then high cholesterol. Another pill. Then sleep apnea. Awesome now I have a whole freaking CPAP machine to keep up with.  And a monthly co-pay for it. Right toward the end I really just felt like I was drowning in it all.

Now I'm on nothing. CPAP is packed up. 

I'm glad you have a determination to see it through somehow. 

I wonder if I would be able to discontinue the cpap. I have been using it since 2004. I was only about 40-50 pounds overweight at that time and it was pretty severe. Now that I have gained all of this weight, I am close to the top pressure that is available on my machine. I still have a high number of apnea events each night. What I wouldn't give for a good nights sleep.

It's like a vicious cycle. I feel bad and am so tired all of the time that I have no energy to exercise. It is hard to think about eating right as well.

I am caretaker of my mom. She is diabetic. She takes 2 different types of insulin just to keep it semi in control.

I go for cardiac clearance tomorrow. I am going to ask this Dr about the best way to discontinue my HBP med. Last time I tried, the entire right side of my body swelled up and it was very painful. Pretty certain that it should not be stopped abruptly. I will be dancing a serious happy dance if I am able to get off of it. Nasty side affects.

Edited by Readytobeme

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17 minutes ago, Readytobeme said:

I wonder if I would be able to discontinue the cpap. I have been using it since 2004. I was only about 40-50 pounds overweight at that time and it was pretty severe. Now that I have gained all of this weight, I am close to the top pressure that is available on my machine. I still have a high number of apnea events each night. What I wouldn't give for a good nights sleep.

It's like a vicious cycle. I feel bad and am so tired all of the time that I have no energy to exercise. It is hard to think about eating right as well.

I am caretaker of my mom. She is diabetic. She takes 2 different types of insulin just to keep it semi in control.

I go for cardiac clearance tomorrow. I am going to ask this Dr about the best way to discontinue my HBP med. Last time I tried, the entire right side of my body swelled up and it was very painful. Pretty certain that it should not be stopped abruptly. I will be dancing a serious happy dance if I am able to get off of it. Nasty side affects.

I can almost guarantee they will want you on all your drugs, until surgery. That way they can have the most stable, healthy you on the operating table. I was on a fairly strict pre-op diet from Feb until Nov 10, my surgery day. I lost 60 lbs during that time, and my PCP would only cut two of the meds in half when I was at the 50 lb mark. My surgeon took me off all of them when I left the hospital after surgery. I would say for now, don't begrudge the meds. They are fulfilling a need in your life right now. Especially if you DO have high blood pressure still. You absolutely do not want to take chances with your heart.  :-)

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@Readytobeme it isn't a forgone conclusion that you won't need a CPAP after weightloss. Not all sleep aponea is tied to being obese, and many thin people have sleep aponea and need CPAPs. All you can do is wait and see what happens.

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5 hours ago, Michael_A said:

I can almost guarantee they will want you on all your drugs, until surgery. That way they can have the most stable, healthy you on the operating table. I was on a fairly strict pre-op diet from Feb until Nov 10, my surgery day. I lost 60 lbs during that time, and my PCP would only cut two of the meds in half when I was at the 50 lb mark. My surgeon took me off all of them when I left the hospital after surgery. I would say for now, don't begrudge the meds. They are fulfilling a need in your life right now. Especially if you DO have high blood pressure still. You absolutely do not want to take chances with your heart.  :-)

Oh, noooooooo. I have no plans to stop any of my meds pre op. I know that the surgeon with want to stop my HBP med asap post op. I want to ask cardiologist about best way to stop them post op because I do not want to experience the same as I have in the past. I feel that cardio knows more about the meds than my surgeon will.

My HBP med contains HCTZ which is a fairly strong diuretic. I know for a fact that the surgeon will want me off them PDQ post op.

Edited by Readytobeme

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3 hours ago, Aussie H said:

@Readytobeme it isn't a forgone conclusion that you won't need a CPAP after weightloss. Not all sleep aponea is tied to being obese, and many thin people have sleep aponea and need CPAPs. All you can do is wait and see what happens.

Yes. I totally agree with this.

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On 1/4/2018 at 7:19 PM, Readytobeme said:

Ha, ha! I may not have worded that right. Amanda is her name. She was just emphasizing that the fact they do cover it is the biggest hurdle and that the rest will fall into place. She is super nice person.

I appreciate the suggestions and support from you guys. I will not give up on this. I will have this surgery one way or another. I have come too far and my weight is having an effect on my health already. I must do it sooner than later.

I just had to go to my sleep Dr today. My bipap machine is set at a fairly high pressure and barely controlling my apnea. I am so ready to start feeling better.

Whatever you do, don’t give up. After surgery, I immediately stopped using my CPAP. I stopped taking all of my diabetes meds nine days after surgery. You are worthy and deserving of WLS!

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Thanks, NT! I will not give up. Even with the extra cost I am facing with my new insurance, it is still less than going to Mexico. It is going to be tough (good thing that I won't need much food for awhile) but, I am going to get through it somehow.

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I hope it works out and you figure a way. I stopped using my cpap right after surgery too. I took it to the hopsital because I had to but they didn't make me use it and I was ok, so I didn't feel like I needed it at home. I tried it one of the nights after being home and hated it and took myself off it (I only had mild sleep apnea). 

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Unfreakingbelievable. The fun just never stops coming. I just found out that UHC does NOT require 6 consecutive months supervised weight loss like my last insurer did.

The good news is that I am most likely going to have surgery next month rather than March.

The bad news for me which was quite shocking is that my policy has gone up by a whopping $200 per month. So, on top of it not having the coverage that it had before, it is also way more expensive. This is getting quite stressful. I need to get this surgery behind me as I may have to drop this policy.

Oh, did I mention that the cost of our meds have tripled from last policy to this one? Been on the phone for 2 days trying to figure it all out.

Edited by Readytobeme

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I count my blessings every day that my DH is career military retired and I'm lucky enough to have my medical care at a military hospital.

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So sorry, @Readytobeme! Having surgery earlier could be very good. Health care costs are so out of hand here.

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1 hour ago, cinwa said:

I count my blessings every day that my DH is career military retired and I'm lucky enough to have my medical care at a military hospital.

We have had very good insurance through this employer for about 25 years now. This is why it has all been so shocking to us. We never thought this would happen to us.

You are very blessed to have guaranteed health insurance though. Going through this just sux really bad.

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@Readytobeme - I'm glad it looks like your surgery will go through and sooner rather than later.

Ah, American health insurance woes - don't get me started. I'm currently enjoying not having to take part in that whole business.

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That does stink.....but when you said your meds went up, do you take meds for your health that you may be able to get off of when you lose weight?  because that would be a silver lining!

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10 hours ago, CheeringCJ said:

That does stink.....but when you said your meds went up, do you take meds for your health that you may be able to get off of when you lose weight?  because that would be a silver lining!

I SO wish that were the case. I am not on many meds at all. It is my husbands meds that have we are concerned about.

Going to a support class today. They should be submitting for approval today after I do my weigh in.

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6 minutes ago, Readytobeme said:

I SO wish that were the case. I am not on many meds at all. It is my husbands meds that have we are concerned about.

Going to a support class today. They should be submitting for approval today after I do my weigh in.

oh, I was hoping it was you so you could cut the cost of that soon!  I hope you get approved and get it underway! :)

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