Suzilla
No Insurance -----> Self Pay!!!
May 14, 2007
When they say it is too good to be true... it is!
:( Disappointment, more research, soul searching, resolve... went thru the entire spectrum of activities and emotions.
Well, the day I finished my requirements for application to health insurance (covered under my husband's), I got a call from the risk managers of the county (thru which we have the insurance) and found out that because they (the county) is self insured any treatment for ANY level of obesity is specifically excluded.. even if medically necessary, etc. etc.... so I changed gears and check out insurance thru my work (to which I could switch over on July 1st)... and found the same exclusion. No way would it be covered, sooo... all the insurance folks I had talked to up to this point actually knew nothing.
Spent the weekend mulling it over and have decided to proceed with self pay - am definately worth it and am gathering the cash.
:) :) Then, my father said he would kick-in half... WOW! was that a surprise.
:) So now, I have appt on the 25th to set up account with hospital/surgical center and take the required class. My surgeon's office manager thinks I'll be looking at surgery the last week in June. Will fit in perfectly to my schedule (and is two months earlier that originally projected when I started this whole trip).
The good that came out of this set back is that I started exercising again, but this time at home (instead of the gym). I am limited to water activities because of knee & heel injuries so have discovered water aerobics and laps swimming. (I had been doingI got a great brace/strap that allows me to swim in my own (15 ft x 30 ft ) pool without stopping. Basically am tied to the side of the side of pool so I can swim non-stop for 30 minutes without moving from the center. I love it. I feel better and am losing weight. It will be perfect for when I need to exercise after surgery.
Also, am still reading Dummie's guide to WLS - love that book - seems like they have been living in my head and picking out my thoughts. Almost done with it - great way to learn.
:( Disappointment, more research, soul searching, resolve... went thru the entire spectrum of activities and emotions.
Well, the day I finished my requirements for application to health insurance (covered under my husband's), I got a call from the risk managers of the county (thru which we have the insurance) and found out that because they (the county) is self insured any treatment for ANY level of obesity is specifically excluded.. even if medically necessary, etc. etc.... so I changed gears and check out insurance thru my work (to which I could switch over on July 1st)... and found the same exclusion. No way would it be covered, sooo... all the insurance folks I had talked to up to this point actually knew nothing.
Spent the weekend mulling it over and have decided to proceed with self pay - am definately worth it and am gathering the cash.
:) :) Then, my father said he would kick-in half... WOW! was that a surprise.
:) So now, I have appt on the 25th to set up account with hospital/surgical center and take the required class. My surgeon's office manager thinks I'll be looking at surgery the last week in June. Will fit in perfectly to my schedule (and is two months earlier that originally projected when I started this whole trip).
The good that came out of this set back is that I started exercising again, but this time at home (instead of the gym). I am limited to water activities because of knee & heel injuries so have discovered water aerobics and laps swimming. (I had been doingI got a great brace/strap that allows me to swim in my own (15 ft x 30 ft ) pool without stopping. Basically am tied to the side of the side of pool so I can swim non-stop for 30 minutes without moving from the center. I love it. I feel better and am losing weight. It will be perfect for when I need to exercise after surgery.
Also, am still reading Dummie's guide to WLS - love that book - seems like they have been living in my head and picking out my thoughts. Almost done with it - great way to learn.
Almost ready to submit to insurance (I think)!
May 08, 2007
Today spent the entire day in Orlando; Went to Nutritionist in the morning and Psych eval in the afternoon. Both went extremely well!! All I have left is my blood tests - which I will do tomorrow AM.
The Nut confirmed a lot that I had already learned (mostly from here) and answered a few questions that I had lingering. I think she can be a great resource, if I need to call on her in the future. She recommended that I read "Weight Loss Surgery for Dummies" - she says it is a wonderful resource.
Psych eval was quick and easy - he even gave me a short note (to be followed with a formal letter) recommending surgery. The secretary was so nice - she actually moved my date up 3 weeks (of course, I called her daily for a week)
I was close to my Surgeon's office so I dropped off the note and some other information I have accumulated.
I am trying to maximize my insurance app (to avoid the requirement of 6 months supervised diet) so I made a "pictoral history" of my weight. I have pictures from age 4 to current (my Nut used these quite a bit in our interview). So, to date I have:
>3 Letters of Necessity (PCP, home Surgeon & Ortho Surgeon)
>Pictoral Weight History
>Written diet/weight history
>Nut Eval
>Psych Eval
>blood tests (tomorrow)
So, I just have to wait until we get these last 3 reports and then it is "wait and see".
The Nut confirmed a lot that I had already learned (mostly from here) and answered a few questions that I had lingering. I think she can be a great resource, if I need to call on her in the future. She recommended that I read "Weight Loss Surgery for Dummies" - she says it is a wonderful resource.
Psych eval was quick and easy - he even gave me a short note (to be followed with a formal letter) recommending surgery. The secretary was so nice - she actually moved my date up 3 weeks (of course, I called her daily for a week)
I was close to my Surgeon's office so I dropped off the note and some other information I have accumulated.
I am trying to maximize my insurance app (to avoid the requirement of 6 months supervised diet) so I made a "pictoral history" of my weight. I have pictures from age 4 to current (my Nut used these quite a bit in our interview). So, to date I have:
>3 Letters of Necessity (PCP, home Surgeon & Ortho Surgeon)
>Pictoral Weight History
>Written diet/weight history
>Nut Eval
>Psych Eval
>blood tests (tomorrow)
So, I just have to wait until we get these last 3 reports and then it is "wait and see".
working on it!
May 03, 2007
Optimistic today!!!
Well am working hard to get all my ducks in a row...
have blood tests and Nut appt. next week,
Psych appt. the week after, and hopefully will be able to submit to insurance shortly after.
For back up, also scheduled another appt with my PCP for next week as the 2nd controlled weight loss effort (in case the insurance asks for 6 months documented period - I'll have already started it).
However, my Dr.'s assistant said that my insurance company (CIGNA) is one of the lenient ones and have not asked for it lately.
I have gotten letters of necessity from my PCP, local surgeon treating me for fibroids and my ortho surgeon - (it was like twisting arms, but they did it) I hope they help!
Well am working hard to get all my ducks in a row...
have blood tests and Nut appt. next week,
Psych appt. the week after, and hopefully will be able to submit to insurance shortly after.
For back up, also scheduled another appt with my PCP for next week as the 2nd controlled weight loss effort (in case the insurance asks for 6 months documented period - I'll have already started it).
However, my Dr.'s assistant said that my insurance company (CIGNA) is one of the lenient ones and have not asked for it lately.
I have gotten letters of necessity from my PCP, local surgeon treating me for fibroids and my ortho surgeon - (it was like twisting arms, but they did it) I hope they help!
Newbie
Apr 27, 2007
Well, I have done my homework, selected and seen my surgeon and am currently completing my requirements for submission to insurance. Made appointments with Nutritionist and Psychiatrist and by the end of May should be able to submit to insurance.
Am hoping to have RNY at the end of June or mid august. Am squeezing it between planned vacations, son's high school graduation, his move to college and my other son's return from college. It is going to be a busy summer, but since I have decided to have this surgery - it can't come fast enough.
Thanks to all on this forum; it has been a large part of my research and gives me first hand knowledge of what to expect. I can't be prepared enough.
NOTE: am unable to find a photo small enough to fit the 20kb parameters of website for my profile (story of my life) so the bear was the best I could comeup with at this late hour.
Am hoping to have RNY at the end of June or mid august. Am squeezing it between planned vacations, son's high school graduation, his move to college and my other son's return from college. It is going to be a busy summer, but since I have decided to have this surgery - it can't come fast enough.
Thanks to all on this forum; it has been a large part of my research and gives me first hand knowledge of what to expect. I can't be prepared enough.
NOTE: am unable to find a photo small enough to fit the 20kb parameters of website for my profile (story of my life) so the bear was the best I could comeup with at this late hour.
About Me
Titusville, FL
Location
29.8
BMI
Surgery
07/18/2007
Surgery Date
Apr 27, 2007
Member Since
