How many ups and downs are there on this "ride" put on by our insurance companies? I knew there were going to be hoops to jump thru, but how was I to know the hoops would change along the way!!! Let's see here is how my journey began, almost 6 months ago....

First met with my primary care doc, who once again said I might want to "think" about losing weight. Really, he said this like I have no idea that I am overweight, no wait obese, morbidly obese and he is introducing a new idea to me. I have (like everyone here) attempted, succeeded and regained, failed and basically had no success. But in a way he had, I had been looking into wls for several months and I came to the decision before ever entering his office that day that I was going to have to have wls to stay healthy. This "come to jesus" meeting about my weight was in the beginning of February. My insurance told me that I needed to have three visits no more than 2 months apart for the "supervised" diet to be considered supervised. So I planned my next visit in April, well within 2 months.

Then I am told that no I have to see the dr monthly for six months, this came from my surgeon, I called the insurance company and confirmed no not every month only three months.

So I continue and now I am told by my insurance that it is 3 visits in 6 months no more than 4 months apart. Oh for the love of it all.....if I didn't have a grasp on the requirements I would go insane and never meet their requirements. But I took a deep breath called again and cleared up the visit requirements a final time, and then started talking money.

This opened another can of worms as I have a maximum out of pocket of 1500.00 per year and this surgery will well exceed that (hospital stay alone) so the surgeon, anesthesiologist, etc will be paid 100%. Well my surgeon was wanting $900 before he would do the surgery and the hospital was wanting 1500.00 and the gas man wanted 500.00. What part of MAXIMUM OUT OF POCKET do these people not get. I have the money to pay but I will not be worried about getting refunds on top of my recovery diet and exercise. I found out that if I pay the hospital on the day of admission they will give me a 25% discount on my portion/responsibility!! Well of course, I will pay so this left the surgeon....hmmmm how do I explain this to them. I told them why I was going to pay the hospital instead of him, his office was very understanding, I was surprised it was easy, I mean really easy they agreed that I would not owe them the 900! The first thing that went my way, yeehaw. I actually did the happy dance.

So come July 9, my paperwork will be submitted I will be waiting on the utilization review department to give the thumbs up, waiting on the beginning of the rest of my life. Let's hope it is the first week of August