wendy645

That's AWESOME!!!! High five to you! Yay! Keep us all updated!

:confused: So after 7 years... yes... seven YEARS... without insurance that will cover this, I finally got a county job with amazing BCBS coverage that includes WLS! I had to work VERY hard to contain myself and not do a happy dance on the table in front of me- including some very funny moves- in employee orientation when I saw the line for Bariatric Surgery! Because of their policy, my benefits don't kick in until the first day of the month following a full calendar month after my first day. A whole lot of fancy words to say I started in November, add a month puts it in December, then the next first day is January 1st. New Year. New chance! Couldn't be more perfect! http://www.napebt.com/summaries/2009_medical_ppo_500_summary.pdf Here is the paper I'm referring to for the following questions: So since I'm new to having insurance I have to pay something other than copay up front for, can someone help me figure this out? It says, "$1,000 access fee, 80%/20% after meeting deductible." It says my maximum coinsurance is $3,000,and elsewhere in the booklet it says that the 20% coinsurance is based on their allowable amount, not the amount of the bill. And I've heard the allowable amount is lower because insurance companies don't want to pay as much as the hospital bills, and the hospitals are happy to get paid anything so they go along with it. Is this right? And I have a $250 deductible. Does this mean that I would end up paying the $250 deductible, the $1,000 access fee, and $3,000 max out-of-pocket co-insurance, bringing my total to $4,250? Are there other costs associated with this that I don't know about? I want to know as much as I can up front. I can't call the insurance reps and talk to them about it yet because I am not insured yet, so they can't look up the policy. At least that was my experience with my last insurance company. And the HR rep said it'd be the same case here. So anyone have experience here? Any words of wisdom? Thanks so much for reading!

Why?? I'm not banded yet and this post is inspiring to me. It's filled with both sides of the story AND advice from tons of people who've made the band work for them. It's the perfect thread, IMO! Keep a positive attitude and you'll get out of it what you put in, as so many posters have mentioned!

OK since no answer on THAT one... will there be another one of these?

Is there any way to record this and save the MP3s? I cannot miss work but this sounds like something I REALLY need right now.

Thank you for reviewing this! I recently picked up the DVD and thanks to you I know to expect weights in the workout! Keep up the good work!!!

I quit my job for many reasons, but a big one was that my insurance laughed at the thought of preventive or mental health. For instance, they covered fills but not the surgery. And nobody needs to talk to anyone or take meds for depression, whatchu talkin' bout, Willis? Not covering the surgery even though I had two doctors who recommended it irked me enough, but the mental thing, well, if you're reading this you understand the mental toll of being obese. So I left my job and enrolled myself in state insurance which covers it after doctor supervised weight loss. Plus, I'm now enrolled in the mental health part of it, which is helpful on many levels. There are two state insurance options in Arizona, one of which requires a 12-month supervised diet, and the other requires a 6-month supervised diet. We found out I'm on the one that's only 6 months! :drool: I had my first appointment to talk about weight loss Saturday. I don't know if they do date or month in general, but I wanted to make sure I had one in January as soon as I was on the new insurance! The last day, but technicalities are the base of any legal/paperwork process so I got that January visit in! hehe I didn't know that having rather good health (all things considered) to begin with was a good thing in the eyes of the insurance company so I- *gulp*- hyperventilated before they took my vitals so my BP was higher than usual. It still ended up only being 127/84. Or was it 124/87? I don't remember. But once I saw the doc, she told me that actually, being in decent health with some budding problems made me an ideal candidate (love that term! :tongue:), because recovery would be easier on me than someone who already had lots of issues, and my age put me in a better position as well because I had more time to benefit from it. I felt silly for faking higher blood pressure. heh. Then again it puts it at pre-hypertensive, which also looks good to nip in the bud. So I'm on my way! Got one appointment down, my next one scheduled. I also found out I have an ulcer and got meds to treat it, and the referral to the bariatric surgeon for a little later. I'm looking at Dr. Berger in Flagstaff since Page, my hometown, is only 2½ hours from there but to Phoenix it's 5. It really hit me how big I am when I looked at what she wrote- "Morbid Obesity- BMI over 46". Wow. I'm so excited! I just need to figure out how to support myself on the income limits to stay on insurance. But that will come in time with faith in the universe/higher power :thumbup: So I had to share! After the crushing denial from my insurance company I ditched them (and a stressful job) and am taking slow steps toward this monumental step in bettering my life! Yay!!!

Hey Banders! :scared2: I just got approved for AHCCCS/Medicaid and was wondering if anyone has had any luck or experience with them. I'm praying they cover it! My last insurance company pretty much told me too bad so sad sucks to be your fat ass! :thumbup: Any experiences?

Hi! I'm in AZ but I thought I'd share this with you... I just lost my job and insurance. I went to one of the clinics in town and talked to their Patient Financial Services reps. I told them I'd just lost my job and insurance but was feeling a bit under the weather, and I asked them if they could help me get on Medicaid so I could be seen. I brought with me all my info, my ID, Passport, bills, last paystubs, residency verification, a letter from my boss saying I was no longer employed or insured, and all that. They did my application right there and they said that Medicaid had a couple more things they needed from me and would call me. They called me the next morning and finalized my application which had been put through as "Expidited" because I'd needed to go to the doctor and therefore had an outstanding medical expense from the day I applied. Basic thing is, my suggestion is to call a local doctor's office and ask if they have a Patience Financial Services rep. Ask that person if they can help you apply in their office because you feel under the weather. Sprained your ankle. ANYTHING that will get you in the system at the doc's office and they'll have to put the app in as "Expidited" and be able to give you a determination as soon as you provide everything they need, so you don't have to wait forever. Otherwise, you'd have to go to the Medicaid office, fill out the paperwork, wait a week for an appointment, then wait for a week while they determine your eligibility and send you an approval or denial letter. Go online and search for your state's Medicaid site and it'll have a list of things you need to bring with you (ID, bills, paystubs, etc.) and take it all to the doc's office. Best of luck! The fact that you were on it recently should help, too!

I was wondering the same thing!

Wow... that's so very kind of you! Good on you! :-D

Well I have Mercy Care right now... and I call them Merciless Care for a reason. They don't cover it, but I'm not sure about AHCCCS. I'm actually voluntarily cutting back my full-time job in this recession to be cut from Mercy care to qualify for AHCCCS in the hopes of getting my healthcare taken care of for prices I can afford :-( Best of luck!

If you were to be in charge of naming an organization that awards grants for wanna-be bandsters to get this done when their insurance says no and they can't otherwise afford it, what would you name it? Ready... go! :tongue2:

I see this was posted on your band date! Congratulations! How did it go? :-)

I'm surprised nobody has answered. Most of the Arizona bandsters live in Phoenix, but I saw in another one of your posts that you were looking for a support group. That was 6 months ago so you've probably found it, but every third Tuesay there's a support group recommended by the Flagstaff Medical Center's Bariatric Program. It's in the same plaza as Bashas' by the hospital (not the Bashas' by WalMart), toward the left end of the plaza. I think it's next to a pizza place. Ironic. LOL It's been over a year since I was in that room so forgive me if my directions are poor! For better info, you can call the FMCBP at 214-3737. At that group you can surely meet some people willing to get together for a bandster's lunch :-) Good luck!

I can't believe this hasn't had crazy replies since the last entry! If money were no object: I'd be banded! I'd buy Microsoft, Sprint, AT&T, etc. and keep all staff so nobody would have to worry about keeping their job after the buyout. I'd buy my mom her own place and a reliable car (right now she's in income-based apts and her car runs about 5 times a year, not for lack of trying) My boyfriend and I would have one heck of a wedding-savings account! We'd have a new house built to our specs in my favorite neighborhood in my hometown, and another in Tucson, a city we both love. We'd both also have reliable cars. I'd buy a place for my best friend who's like a sister to me. I'd fix her car. I'd donate to the local Domestic Violence shelter, which saved my mum's life. I'd have one heck of a retirment account. I'd put massive amounts in CDs for later. I'd set up a fully-funded college fund for my god-daughter. My boyfriend and I would tour the world, taking in everything we always wanted to. I'm whisk all my closest friends and family away to a fancy spa and spend several days resting, relaxing, and being pampered. And I would, of course, make sure they didn't miss out on any wages while they were gone! I'd buy all the hotels on the Las Vegas Strip. And I'd set it up so that each one's profits went to a different charity, though it would not be public knowledge.

Makes sense! Neat, thank yuo for sharing that! :smile2:

Well, don't go for Mercy Care Az. *sigh* Best of luck!!!

I don't have much to offer besides my support. I was denied, too, so I'll be keeping an eye on this thread. Best of luck!!!