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My Insurance Nightmare - Why I've Been Doing This For 9 Months.

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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.

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  1. Old Comment
    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.
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    Posted 10-03-2008 at 11:33 PM by thornhailweb thornhailweb is offline
  2. Old Comment
    janesays's Avatar
    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!
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    Posted 10-04-2008 at 02:50 AM by janesays janesays is offline
 

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