(Chicago) New insurance does not cover Fills, please help.

[MissMe27 0]

Well I know right now because I just got the news I might be over reacting but I'm heart broken.

I had my surgery on June 5th. My insurance covered everything! I didn't pay a dime. I had a couple fills last year and then my husband's employer changed to United HealthCare Choice Plus and I had to find a new doctor that was "in-network". So I thought I found one, I had my fill scheduled for today (I SOOO NEED IT) and I just got a call that our new insurance doesn't cover bariatric at all. So in order to get my fill there I would need to pay $250.

Now I know that there has to be places that are cheaper. Can anyone suggest some in my area? I live in Chicago but can drive to the suburbs if need be. I'm just worried now, God forbid, something went wrong in the future then what? :wink:

So sad. Thanks.

[jacelynn 0]

That sucks! I have UHC choice plus also and they cover everything! It must be the employer. Sorry to hear about your difficulties.

[MissMe27 0]

It has to be the employer... because I know that the new doctor I was suppose to see today is "in-network" for them so it must be something the employer asked to have removed from their policy.

Please if anyone can refer me to a place I can get a fill for cheaper I'd really appreciate it.

And to think I was upset about having to now pay a $40 specialist copay for fills now... :wink:.

Times are just hard.

[candeta 0]

I live in Washington and had to self pay for my Band and will also have to pay for my fills. $250 is actually a good price for a fill. I have seen them between $175 (by a nurse) and $600. Pay the $250 with a good doctor and be happy you didn't have to pay for the surgery. You are blessed to have had the coverage to get the surgery.

[MissMe27 0]

IF, my economic situation was diff., I would not be here trying to find a cheaper place to go. $250 is just NOT an option for me or my family at this point.

Thanks anyway.

[candeta 0]

Sounds like you won't be getting a fill if you are unwilling to make a sacrifice and pay for it. A good majority of us on this forum sacrificed a lot and had to pay out of pocket for the whole thing... so i don't think you are going to get much sympathy on here for having to pay for a fill.

Glad you had good insurance and have not had to "pay a penny" so far. Maybe you can find someone on a corner somewhere that will inject you with something "cheaper"... but if you want a reputable doctor to do a real fill you will have to pay... and $250 is at the bottom of the fee scale for a fill... unless you are willing to risk problems.

[MissMe27 0]

Wow, I guess working extra hours to pay the mortgage and child's tuition isn't enough sacrifice.

We sacrifice SO MUCH just to pay our necessities right now, please don't sit there and judge me assuming that I wouldn't sacrifice even MORE if I could. Not everyone has the same income, bills, children, tuitions, family members with other health related costs, etc.

I get what you are saying... you have no idea how much I prayed that my insurance covered my surgery. I praised God so much when it finally happened. I'm simply, due to MY OWN financial situation, trying to find thru fellow LapBanders, local referrals.

Have a great day.

[jacelynn 0]

I don't see anywhere on her post where she was asking for sympathy, just help. No one knows this womans situation except for her self, so quit badgering her... She was just asking a question!

[candeta 0]

You are correct... we don't all have the same bills/needs... some of us live within our means and take care of elder family members as well as our own children... some of us even do it after horible divorces that leave us homeless with nothing more than our smiles to get us started again. I do not have a high paying job, I am simply a hard worker who works my butt off to take care of my mortgage, 3 children, 83yo grandmother (with no Income), and myself. $250 is a lot of money to me... and takes me 3 days to earn... but without my health I can not provide for my family, so it is a priority to me.

Maybe you can pray for someone else to pay for it for you, so you can continue to pay for whatever it is you and your husband find as priorities.

Good luch in your search for a "cheap" doctor.

[MissMe27 0]

Wow, so aggresive, you'd almost think I was asking YOU to pay it for me. Listen I wish you the very best in life. Good luck with it all. I still don't see how this affected you enough to go off like that but hey, to each their own.

jacelynn: thanks hun, I had to re-read my post just to make sure I didn't in fact ask for sympathy somewhere. LOL. Take care! And hopefully someone who isn't offended by my post will continue to share their opinions.

[candeta 0]

IF, my economic situation was diff., I would not be here trying to find a cheaper place to go. $250 is just NOT an option for me or my family at this point.

Thanks anyway.

This is the post that set me off! I simply told of my research regardig pricing and that $250 is a good price for a fill and this is what I got... so Wahhhh... if you want to cry about it, and yell at people, go yell at your husbands employer! You don't need to be YELLING on here!

Grow up and quit expecting everyone to pay for your mistakes... no one got you fat, you did it on your own!

[MissMe27 0]

Hm, I guess I'll be careful with my forum "yelling" from now on. Sorry about that. :eek:

I guess I'm the only fat person on here. :wink:

[kiz 1]

Check back with your original doctor, if you haven't. Some give self-pay patients a bit of a break. I had one year of fills included, and that year is up. If I need additional fills, I think an in-office fill is just over $100 (although I forget how much it is exactly because I haven't needed one), but fills done under fluoro are around $700 (yikes!).

Maybe your surgeon would work out something for you since he did your band surgery in the first place.

Good luck.

[MissMe27 0]

That's a great idea, I'm going to email my surgeon right now.

I appreciate that.

[kiz 1]

I hope it works out for you, MissMe. I understand that a doctor that didn't due the actual surgery might charge more for fills because he didn't get the money on the front end for doing the surgery, but hopefully the original doctor might work out something for you now that your insurance has changed.