My Insurance Nightmare - Why I've Been Doing This For 9 Months.
Posted 10-03-2008 at 03:37 PM by BikiniBeachy
Here's a shoirt recap on why I've been on this site so long, yet still am not banded.
This is actually the third insurance go-around I've attempted since March. I started with Kaiser and they denied me but, it was pointless to appeal because I had an exclusion in my policy since my mother was buying an individual plan. It was horrifying, because I had been lied to and told they did have it covered while we were shopping around for insurance. That's when I learned to document everything, because I could've sued their asses if I had documented that I had been told they covered it by a sneaky salesperson juist trying to get us to buy the policy! The second company had a $7,500 max, which is around 35% coverage with Dr Snyder, I COULD NOT afford to pay 9k, if I was going to do that I would honestly go to Mexico so I didn't have to get insurance approval! I then took out a student loan for 10k and began to research Mexican DRs and by this point it was summer and I was getting desperate. iI then saw a special about student loans and went into a panic mode, droive to the post office and returned the un cashed check within 30 days. They are trying to say it was 31 days but I have record of EVERYTHING so hopefully they will leave me alone, they was $600 just for interest for the first 30 days, loans are horrifying! That may come back to bite me one day, but I haven't heard from them and when I called they say my account was at zero "yea right..."
Anyway, my mother decided to get a new job (she had no idea I was looking into surgery, I wasn't ready to tell her) and then as soon as she did I explained to her what i had been up to and she asked her employer if they covered bariatric surgery, and they said they do 100%. I had also been tested for Sleep Apnea during this time and been diagnosed with both that and GERD,
**Whew, that's lots there*** Anyway, I jumped on the seminar waiting list so I could get on the consult waiting list and allt he while I went down every waiting list for the evaluations, Upper GI, Pulmonary, Psych (what a nightmare my DR was, he didn't want me to have the surgery, but he was an 90 year old, out of touch jerk that got upset I wouldn't answer my cell phone when he called me incessantly AFTER my appointment..total creep, and my surgeon agreed.) And a few others that are slipping my mind at the time. I have spent every single second of my life trying to waste no time, but it's nearly taken 9 months and finally insurance has my paperwork.
Sorry for the long story, but there's my experience, lol. I am hoping they don't deny me, I really don't know why they would, since i have a 41 BMI and 2 Co Morbs and they only require 35BMI w/ One CoMorb or 40+ so chances are good, unless they say something stupid about a 'diet' (which I haven't read ANYTHING about in the policy they sent me) or that I haven't been with the insurance long enough.
This is actually the third insurance go-around I've attempted since March. I started with Kaiser and they denied me but, it was pointless to appeal because I had an exclusion in my policy since my mother was buying an individual plan. It was horrifying, because I had been lied to and told they did have it covered while we were shopping around for insurance. That's when I learned to document everything, because I could've sued their asses if I had documented that I had been told they covered it by a sneaky salesperson juist trying to get us to buy the policy! The second company had a $7,500 max, which is around 35% coverage with Dr Snyder, I COULD NOT afford to pay 9k, if I was going to do that I would honestly go to Mexico so I didn't have to get insurance approval! I then took out a student loan for 10k and began to research Mexican DRs and by this point it was summer and I was getting desperate. iI then saw a special about student loans and went into a panic mode, droive to the post office and returned the un cashed check within 30 days. They are trying to say it was 31 days but I have record of EVERYTHING so hopefully they will leave me alone, they was $600 just for interest for the first 30 days, loans are horrifying! That may come back to bite me one day, but I haven't heard from them and when I called they say my account was at zero "yea right..."
Anyway, my mother decided to get a new job (she had no idea I was looking into surgery, I wasn't ready to tell her) and then as soon as she did I explained to her what i had been up to and she asked her employer if they covered bariatric surgery, and they said they do 100%. I had also been tested for Sleep Apnea during this time and been diagnosed with both that and GERD,
**Whew, that's lots there*** Anyway, I jumped on the seminar waiting list so I could get on the consult waiting list and allt he while I went down every waiting list for the evaluations, Upper GI, Pulmonary, Psych (what a nightmare my DR was, he didn't want me to have the surgery, but he was an 90 year old, out of touch jerk that got upset I wouldn't answer my cell phone when he called me incessantly AFTER my appointment..total creep, and my surgeon agreed.) And a few others that are slipping my mind at the time. I have spent every single second of my life trying to waste no time, but it's nearly taken 9 months and finally insurance has my paperwork.
Sorry for the long story, but there's my experience, lol. I am hoping they don't deny me, I really don't know why they would, since i have a 41 BMI and 2 Co Morbs and they only require 35BMI w/ One CoMorb or 40+ so chances are good, unless they say something stupid about a 'diet' (which I haven't read ANYTHING about in the policy they sent me) or that I haven't been with the insurance long enough.
Total Comments 2
Comments
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So sorry about what you are going through. I am going a few rounds with Kaiser myself. Insurance companies can be a nightmare come to life. I will pray that things work out for you. Let us know how it all goes.Posted 10-03-2008 at 11:33 PM by thornhailweb
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i'm so sorry this has been so rough for you. i've been at this for two years and finally decided to just go the self-pay route... much less stressful (except for on my wallet.. but i look at it as an investment!) i really hope this works out for you. keep us updated, and hopefully by this time next year we'll both be banded and healthy!Posted 10-04-2008 at 02:50 AM by janesays























