Time to pout... screw you BCBS!!

[MollySigns2009 0]

So I have insurance, GREAT insurance at that. I work in a hospital for god's sake! And I called today to see if my surgery would be covered, and they said it would be after I've been an employee for 3+ years. Thats 21 months away! Are you kidding me?! I can't afford to wait 2 more years! I'll be a monster! Hell, I already am a monster. If my nephew asks me one more time when I'm going to have my baby I'm going to kill him. I love him to death but every time I feel like crying. Has anyone else had this issue with having to hold the insurance for 3 years before approval? Is there any way around it? I cant do 2 more years like this! I was hoping to get banded in September for my birthday! Please, someone tell me what to do!!

[tinksmom 0]

That restriction was probably added by your employers since it is not a standard BCBS requirement. It stinks but look at it from the employer's viewpoint: they are probably worried that people will work for them just for the insurance (like a lot of other jobs) and specifically for just long enough to get elective surgery done. All you can do is to talk to your benefits representative with your employer and see if they are considering changing...or updating...the policy. If others you speak to will also question this you might be able to persuade them that WLS is far more likely to keep you on the job than having the excess weight.

[Llyra 3]

Are other elective surgeries covered by your insurance before three years are up? If so, you may have an ADA claim. If not, you may still have a claim or you may be sunk, but talk to your rep. My husband has worked for a regional medical center for 20+ years. When he started, antidepressants, anxiety meds, bipolar meds, biofeedback, counseling, and all other mental health measures were not covered by insurance. Now they are, but it took a bunch of people complaining about discrimination and looking at legal action to get it changed.

Even with our hospital's relatively liberal outlook on bariatric surgery, the insurance company dragged its feet for so long on approving my surgery that I'd nearly given up, as had the bariatric nurse in charge of the program. But they came through and I hope yours will, too. Enlist the aid of your primary care physician- if she recommends the surgery to improve secondary weight-related problems, it might help. My doctor really went to bat for me on this, god bless her.

You aren't a monster. You are cute as a litter of kittens. Your nephew is a monster, however much you love him. I put up with "funny fat girl jokes" from my family for far too long to ever be patient with this kind of "teasing" again. He's either being deliberately cruel, in which case he needs to be told to shut up once and for all, or he's very young and/or dense and should be taught not to make personal remarks. My sympathy to you.

Edited July 22, 2010 by Llyra

[MollySigns2009 0]

I called the surgeon to talk to their insurance specialist and had to leave a voicemail, and today I called the HR office where I work to see if they had any insight and left another voicemail. this is going to be me more work than I originally thought! boo! and my nephew is 5, so he really just doesn't get it.

[ebeeze824 1]

if your nephew is anything like my bad butt nephew he knows exactly what he is doing. mine just recently turned six and believe me he calls me Big Momma and always wants to lift my shirt up to see his auntie's fat belly..........go figure is mother is about 120 soaking wet.......

keep trying with the insurance company and with the human resources department at work you may get a blessing in disguise without even knowing it

[honk 780]

At five he is old enought to stop being rude. You need to sit him down and tell im it is not nice to make fun of people. Does he laugh at people in wheelchairs or children with Down's? Someone needs to teach him manners. Rude behavior in chidlren is just rude, not funny, not cute. Just wait until he says something about a stranger he and or his parents may get a lesson they were'nt planning on. And yes I have 3 nephews and not one of them every made comments like that to me. EVER. I certainly would not baby sit for this child until he learns manners and if your brother/sister in law ask why not tell them.

[NikkiChantel 0]

So I have insurance, GREAT insurance at that. I work in a hospital for god's sake! And I called today to see if my surgery would be covered, and they said it would be after I've been an employee for 3+ years. Thats 21 months away! Are you kidding me?! I can't afford to wait 2 more years! I'll be a monster! Hell, I already am a monster. If my nephew asks me one more time when I'm going to have my baby I'm going to kill him. I love him to death but every time I feel like crying. Has anyone else had this issue with having to hold the insurance for 3 years before approval? Is there any way around it? I cant do 2 more years like this! I was hoping to get banded in September for my birthday! Please, someone tell me what to do!!

Honey I am so sorry. Did you talk to the Insurance company? I mean if they told you no then I would fight it. If you are covered under insurance, you are covered. I am upset as well because I want to get banded for my birthday too. Unfortunately I have Kaiser and they won't cover it. Good luck to you. Let me know what happens.

Nikki

[Beachbunny 5]

Well the good thing is you are covered ! it will just take time. Even if you were covered now it takes a month or two to get all appointments under your belt for the surgery. Best of luck to you on your new journey.

Jennifer