Mewizza 3 Posted January 5, 2011 I hope everyone is reading this, when this happen to me today I was shocked & blown away. I hope this never happens to anyone else. Here's what happened. I have to back track a little so please bear with me. So I switch my insurance @ the 1st of the year like everyone else, I went back to my mother insurance due to the new Obama healthcare law, I switched for a couple of reasons but that beside the point before I switch I did my research before dropping my insurance from my company and going to my mothers. I called to make sure the band was covered, how much it was gonna cost, & if I needed anything to do to be pre-approved I mean I asked everything. They told me everything so I switch because it was only gonna cost me $900 the everything in my health care would be covered for the year instead of my insurance I would have had to pay $2000 then pay %20 of everything for the year. So when I resubmitted with my new insurance I was DENIED! I couldn't believe what I was hearing, I kept asking what do you mean I was denied she said my new insurance doesn't cover any WLS how could this be??? I dropped my own insurance so I could be covered underneath my mom "better" insurance. I completely felt like my life was over. I kept screaming this can't be.. this can't be.. I know that poor lady felt bad for me. Well I refused being denied as a answer so I called my insurance & the confirmed my new insurance no longer cover WLS so I cry & ask a million questions like if there was loop hole or if it was a medical necessary.. I mean I asked everything.. she double checked everything.. she said in 2010 we covered it but now in 2011 we no long carry it.. of course I was crying and panicking because I was looking forward to restarting my life. This is something I've thought about since I was 18 and finally was ready to do it.. so I get off the phone because I have to accept what the insurance say because well they are my insurance.. so I'm crying at work thing what do I do? I should have stayed with my old insurance.. while I was talking back with the WLSC i get a call from a doctor. The rep I was talking to felt so bad about what happened she went to her manager & they stated they were gonna investigate & call the company to see why they stopped coverage, she then stated it might be a computer error.. I prayed hard that it was a error. I called my mom & made her get off a factory line to call me so I could tell her everything that was going on.. she went to her HR because my mom informed me that her company couldn't have changed their coverage due to all the employees are in a union & if any changes were made they would have to approve them & all employees would have be notified. My mom then called me after she was on the phone with the insurance company & the insurance company accidently had a computer error when renewing the 1s of the year & removed the coverage for WLS. I couldn't believe this. A FREAKING ERROR. I'm glad it was a error but I was seriously stressing. I can only imagine what else they might have messed up.. I mean what if I was a car accident & they didnt cover the hospital & they just said oh we no long cover when your in the hospital & you call your insurance company & they confirm what else do you do.. So I want everyone to be a wear & warned that insurance companies do make mistakes & you have to make sure they are covering what they are supposed. Write down everyone you spk with & ther operator #. So after a day of stressing & crying & thinking I will have to pay 18k for a surgery I need and want they finally said the error is being fixed & it will be covered.. now to I wait for the WLSC to call back so I can tell her to resubmit it back to insurance. DON'T EVER GIVE UP ON YOUR DREAMS & NEVER LET ANYONE GET IN THE WAY. Share this post Link to post Share on other sites
mattie7632 24 Posted January 5, 2011 Welcome to the world of insurance. It will only get worse if/when Obamacare completes. I hope everyone is reading this, when this happen to me today I was shocked & blown away. I hope this never happens to anyone else. Here's what happened. I have to back track a little so please bear with me. So I switch my insurance @ the 1st of the year like everyone else, I went back to my mother insurance due to the new Obama healthcare law, I switched for a couple of reasons but that beside the point before I switch I did my research before dropping my insurance from my company and going to my mothers. I called to make sure the band was covered, how much it was gonna cost, & if I needed anything to do to be pre-approved I mean I asked everything. They told me everything so I switch because it was only gonna cost me $900 the everything in my health care would be covered for the year instead of my insurance I would have had to pay $2000 then pay %20 of everything for the year. So when I resubmitted with my new insurance I was DENIED! I couldn't believe what I was hearing, I kept asking what do you mean I was denied she said my new insurance doesn't cover any WLS how could this be??? I dropped my own insurance so I could be covered underneath my mom "better" insurance. I completely felt like my life was over. I kept screaming this can't be.. this can't be.. I know that poor lady felt bad for me. Well I refused being denied as a answer so I called my insurance & the confirmed my new insurance no longer cover WLS so I cry & ask a million questions like if there was loop hole or if it was a medical necessary.. I mean I asked everything.. she double checked everything.. she said in 2010 we covered it but now in 2011 we no long carry it.. of course I was crying and panicking because I was looking forward to restarting my life. This is something I've thought about since I was 18 and finally was ready to do it.. so I get off the phone because I have to accept what the insurance say because well they are my insurance.. so I'm crying at work thing what do I do? I should have stayed with my old insurance.. while I was talking back with the WLSC i get a call from a doctor. The rep I was talking to felt so bad about what happened she went to her manager & they stated they were gonna investigate & call the company to see why they stopped coverage, she then stated it might be a computer error.. I prayed hard that it was a error. I called my mom & made her get off a factory line to call me so I could tell her everything that was going on.. she went to her HR because my mom informed me that her company couldn't have changed their coverage due to all the employees are in a union & if any changes were made they would have to approve them & all employees would have be notified. My mom then called me after she was on the phone with the insurance company & the insurance company accidently had a computer error when renewing the 1s of the year & removed the coverage for WLS. I couldn't believe this. A FREAKING ERROR. I'm glad it was a error but I was seriously stressing. I can only imagine what else they might have messed up.. I mean what if I was a car accident & they didnt cover the hospital & they just said oh we no long cover when your in the hospital & you call your insurance company & they confirm what else do you do.. So I want everyone to be a wear & warned that insurance companies do make mistakes & you have to make sure they are covering what they are supposed. Write down everyone you spk with & ther operator #. So after a day of stressing & crying & thinking I will have to pay 18k for a surgery I need and want they finally said the error is being fixed & it will be covered.. now to I wait for the WLSC to call back so I can tell her to resubmit it back to insurance. DON'T EVER GIVE UP ON YOUR DREAMS & NEVER LET ANYONE GET IN THE WAY. 1 Russian_BANDit_inNY reacted to this Share this post Link to post Share on other sites
Mewizza 3 Posted January 5, 2011 I have to say the good thing about that is I can be on my mother insurance which of course is better then the company I work for. I mean I'm saving my own money because my company makes me pay for my own insurance & it doesnt effect my mother because her company provides their insurance for free.. but it's better, saving me money & I don't have to be in college & can stay insured up until my 26th birthday. Some of the bill does really help. 1 TucsonAnnie reacted to this Share this post Link to post Share on other sites
Mewizza 3 Posted January 5, 2011 I'm so nervous.. I called my rep @ WLSC she resubmitted my paperwork now all I have to do it wait. Share this post Link to post Share on other sites
GavynsMum 1 Posted January 5, 2011 Good luck. Insurances can be very tricky. Make sure you always get things in writing. Share this post Link to post Share on other sites
lindas0809 0 Posted January 5, 2011 Welcome to the world of insurance. It will only get worse if/when Obamacare completes. In your opinion - but to the millions without any healthcare options it may be better. 1 TucsonAnnie reacted to this Share this post Link to post Share on other sites
Mewizza 3 Posted January 7, 2011 They are still saying my surgery is still denied sayin they still cover it.. but the insurance says they still havent updated the system.. im so scared. Share this post Link to post Share on other sites
cheryl2586 3,053 Posted January 7, 2011 Why in the world would you switch insurance before your surgery is even done? That makes no sense to me. If you are planning any surgery at all never switch insurance before you have it done. It has nothing to do with obama care either it has everything to do with insurance companies and prexisting things they wont cover it 90 percent of the time. Share this post Link to post Share on other sites
rowekins 1 Posted January 7, 2011 My work switched insurance companies for me at the first of the year. I had no say. My surgical consultation was yesterday. I've been stressing SO much over everything. I understand how you feel. They say something is not covered, then they change their minds. AAHHH! I didn't know we were switching insurance companies until after I started the band appointments. If I had, I would have just waited until January. Good luck! Share this post Link to post Share on other sites
Stephy5 33 Posted January 7, 2011 I hope everyone is reading this, when this happen to me today I was shocked & blown away. I hope this never happens to anyone else. Here's what happened. I have to back track a little so please bear with me. So I switch my insurance @ the 1st of the year like everyone else, I went back to my mother insurance due to the new Obama healthcare law, I switched for a couple of reasons but that beside the point before I switch I did my research before dropping my insurance from my company and going to my mothers. I called to make sure the band was covered, how much it was gonna cost, & if I needed anything to do to be pre-approved I mean I asked everything. They told me everything so I switch because it was only gonna cost me $900 the everything in my health care would be covered for the year instead of my insurance I would have had to pay $2000 then pay %20 of everything for the year. So when I resubmitted with my new insurance I was DENIED! I couldn't believe what I was hearing, I kept asking what do you mean I was denied she said my new insurance doesn't cover any WLS how could this be??? I dropped my own insurance so I could be covered underneath my mom "better" insurance. I completely felt like my life was over. I kept screaming this can't be.. this can't be.. I know that poor lady felt bad for me. Well I refused being denied as a answer so I called my insurance & the confirmed my new insurance no longer cover WLS so I cry & ask a million questions like if there was loop hole or if it was a medical necessary.. I mean I asked everything.. she double checked everything.. she said in 2010 we covered it but now in 2011 we no long carry it.. of course I was crying and panicking because I was looking forward to restarting my life. This is something I've thought about since I was 18 and finally was ready to do it.. so I get off the phone because I have to accept what the insurance say because well they are my insurance.. so I'm crying at work thing what do I do? I should have stayed with my old insurance.. while I was talking back with the WLSC i get a call from a doctor. The rep I was talking to felt so bad about what happened she went to her manager & they stated they were gonna investigate & call the company to see why they stopped coverage, she then stated it might be a computer error.. I prayed hard that it was a error. I called my mom & made her get off a factory line to call me so I could tell her everything that was going on.. she went to her HR because my mom informed me that her company couldn't have changed their coverage due to all the employees are in a union & if any changes were made they would have to approve them & all employees would have be notified. My mom then called me after she was on the phone with the insurance company & the insurance company accidently had a computer error when renewing the 1s of the year & removed the coverage for WLS. I couldn't believe this. A FREAKING ERROR. I'm glad it was a error but I was seriously stressing. I can only imagine what else they might have messed up.. I mean what if I was a car accident & they didnt cover the hospital & they just said oh we no long cover when your in the hospital & you call your insurance company & they confirm what else do you do.. So I want everyone to be a wear & warned that insurance companies do make mistakes & you have to make sure they are covering what they are supposed. Write down everyone you spk with & ther operator #. So after a day of stressing & crying & thinking I will have to pay 18k for a surgery I need and want they finally said the error is being fixed & it will be covered.. now to I wait for the WLSC to call back so I can tell her to resubmit it back to insurance. DON'T EVER GIVE UP ON YOUR DREAMS & NEVER LET ANYONE GET IN THE WAY. So happy for you that this worked out. So sorry you had the emotional drain of dealing with it. You are so right. My friend who had a different WLS was denied by her insurance on 11/24 so she self paid the doc and the hospital. Luckily her doctor called 4 days before the surgery and said we hear your insurance does cover so we are going to resubmit. They did and found out that at the beginning of November they started covering her WLS> But somehow the insurance didn't include it in the computer system. Insurance companies make lots of mistakes. Thanks for bringing this to everyones attention and congrats again! Share this post Link to post Share on other sites
Mewizza 3 Posted January 7, 2011 I switched insurance because it was cheaper for me.. & I was only allowed to switch because of the new healthcare laws.. if they hadnt went in effect.. I'm 22 & not in college that would mean I wouldnt be allowed on my parents insurance.. My company I work for has insurance but it's a 20/80 my mothers insurance is a 100% plan which mean I'm saving thousands of dollars... 1. i don't have to pay for it neither does my mother because she is in a union. 2. It's better insurance. BCBS stated it was a error on their part & they are fixing it.. they just havent fixed it yet. i'm just stressing because not only did they make a mistake they are causing huge stress in my life.. the lapband mean more then anything to me right now.. it means a better life for me.. it means a future life for me.. if I could do it by myself i would wouldnt we all? I just need to be patient & wait but they are toying with my emotions right now.. they said it would be fixed the next day.. & it's thursday it was supposed to be fixed yesterday.. they arent sure when they will fix it. Share this post Link to post Share on other sites
Noturningback15 45 Posted January 7, 2011 If the Obamacare would have actually been in affect it would have actually helped you more than likely in your switch instead of hurting you:) Obesity might just be considered a pre-existing condition one day and could be denied without the new laws they want to put in place? I am not positive and that's why I said may. I guess lesson learned now you can rejoice and be a bander with the rest of us! Yea!!!!! Share this post Link to post Share on other sites
txtonya 3 Posted January 7, 2011 I don't complain about my health insurance because something is better than nothing. I know people who don't have anything and they worry about very serious health issues. I don not pretend to understand the Oboma ealth care plan, but if it will help those without insurance get the health care they need I am all for it . I appreciate that my insurance covered my lapband and I will work very hard to make sure I do everything I can to lose the weight and keep it off. 1 JessicaA reacted to this Share this post Link to post Share on other sites
Dreamingof139 3 Posted January 7, 2011 I switched insurance because it was cheaper for me.. & I was only allowed to switch because of the new healthcare laws.. if they hadnt went in effect.. I'm 22 & not in college that would mean I wouldnt be allowed on my parents insurance.. My company I work for has insurance but it's a 20/80 my mothers insurance is a 100% plan which mean I'm saving thousands of dollars... 1. i don't have to pay for it neither does my mother because she is in a union. 2. It's better insurance. BCBS stated it was a error on their part & they are fixing it.. they just havent fixed it yet. i'm just stressing because not only did they make a mistake they are causing huge stress in my life.. the lapband mean more then anything to me right now.. it means a better life for me.. it means a future life for me.. if I could do it by myself i would wouldnt we all? I just need to be patient & wait but they are toying with my emotions right now.. they said it would be fixed the next day.. & it's thursday it was supposed to be fixed yesterday.. they arent sure when they will fix it. My experience with BCBS of Idaho has been AWFUL.... good luck. Share this post Link to post Share on other sites
mattie7632 24 Posted January 7, 2011 Well my opinion is an educated one. If you work in and understand insurance you would realize what's already happening in the industry and how in the long run it will help nobody. But as usual, most Americans are concerned with me-me-me and what they can get off someone else, so right now the delusion is that this will help you. In your opinion - but to the millions without any healthcare options it may be better. Share this post Link to post Share on other sites