pffffftttttt.....
The insurance coordinator at the hospital called me today to discuss my HMOs requirements for bariatric surgery. I meet it all except one part:
"Medical documentation that the member has failed a medically supervised weight reduction program for a duration of at least 18 consecutive months"
I don't have 18 consecutive months of supervised diet. At best, I have 6 months.
Lucky for me, this week is my open enrollment week at work to switch to PPO coverage. The change would be in effect 2/1, so I'm hoping that I can see the doctor shortly after that. In the meantime, I've got my doctor sending my records over to the surgeon anyway, in the hopes that it will speed up my process once my insurance gets switched... really hoping that goes smoothly and I don't have an issue with them verifying coverage right after switching plans.
I'm a bit shocked at the amount of diet time that my medical group requires. It's really quite excessive, considering the medical group is with BCBSIL and BCBSIL themselves don't required ANY supervised diet AT ALL. So why is the medical group sweatin' me for that kinda diet???
I was already considering switching to PPO because this whole process so far has been really difficult. I've had so many ups and downs with this and I'm not much further along in this process than when I started back in July. I never understood why people complained about HMOs -- I GET IT NOW. I've had enough, and maybe next year after surgery I can go back to an *** because it's cheaper, but as far as all the BS the *** has already put me through and I'm NOT EVEN CLOSE to getting approved, I think PPO is a much better bet. It might cost more, but my health and my well being is worth any price!
Anyway, long story LONG -------------------------------------------- I haven't got much else to update. Still been in a bit of a New Year slump, just tired and cranky and anti-social. Starting to snap out of it, though and really am hoping this year will be my year to shine. I've also still been in slacker mode since the holidays with going to the gym, so I'm sure that's part of the slump also. I'm gonna get my butt there in the morning, though. Time to get this back in motion and keep it moving!
HAPPY NEW YEAR! (late, I know - but still sincere)
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