Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Insurance changes



Recommended Posts

Ok, here's the story.. I need to put my mind at rest, just a bit!

I work for a coutny agency, as a caseworker with individuals who have intellectual disabilities. Recently we found out the government was seeking to privatize us. This is all happening January 1,2012. For the most part, I am pretty okay with it all, even, dare I say, excited? However, this means an insurance change. I currently have Capital Blue Cross, which has paid for everything. The new company has Capital Blue Cross also, which I am enrolling into. This agency's insurance covers the band, if its medically necessary. I am trying very hard to lose 75 pounds by mid December. This will put my BMI at 37.9. My question is this.. Is it still "medically necessary" for me to get fills at that point, or am I going to be paying for them out of pocket? (which isn't horrible, they are about 115.00 for a fill). The insurance will pay for the doctor visit for sure.

I'm very near my sweet spot now, I have 8.5 cc in a 14cc band. I have a fill scheduled for Nov 25, if I need it. Should I go? I've lost 12 pounds since my last fill, and I don't even know if my doc is going to give me a fill because that was about 3 weeks ago! UGH so many questions about this health insurance stuff!

Has anyone run into this?

I'm not looking for insurance advice, just looking to hear if anyone has experienced this and what the outcome was, that's all.

Share this post


Link to post
Share on other sites

I can definitely vouch for not getting a fill if you don't need one. I know you are anxious because your insurance is changing, I am too. And we are going to CIGNA......blaaah. My advice is this, save the $115 and put it in an envelope. Then, when you really are feeling like you need a fill, you already have the money saved. Whether insurance will pay for it or not :-)

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • rinabobina

      I would like to know what questions you wish you had asked prior to your duodenal switch surgery?
      · 0 replies
      1. This update has no replies.
    • cryoder22

      Day 1 of pre-op liquid diet (3 weeks) and I'm having a hard time already. I feel hungry and just want to eat. I got the protein and supplements recommend by my program and having a hard time getting 1 down. My doctor / nutritionist has me on the following:
      1 protein shake (bariatric advantage chocolate) with 8 oz of fat free milk 1 snack = 1 unjury protein shake (root beer) 1 protein shake (bariatric advantage orange cream) 1 snack = 1 unjury protein bar 1 protein shake (bariatric advantace orange cream or chocolate) 1 snack = 1 unjury protein soup (chicken) 3 servings of sugar free jello and popsicles throughout the day. 64 oz of water (I have flavor packets). Hot tea and coffee with splenda has been approved as well. Does anyone recommend anything for the next 3 weeks?
      · 1 reply
      1. NickelChip

        All I can tell you is that for me, it got easier after the first week. The hunger pains got less intense and I kind of got used to it and gave up torturing myself by thinking about food. But if you can, get anything tempting out of the house and avoid being around people who are eating. I sent my kids to my parents' house for two weeks so I wouldn't have to prepare meals I couldn't eat. After surgery, the hunger was totally gone.

    • buildabetteranna

      I have my final approval from my insurance, only thing holding up things is one last x-ray needed, which I have scheduled for the fourth of next month, which is my birthday.

      · 0 replies
      1. This update has no replies.
    • BetterLeah

      Woohoo! I have 7 more days till surgery, So far I am already down a total of 20lbs since I started this journey. 
      · 1 reply
      1. NeonRaven8919

        Well done! I'm 9 days away from surgery! Keep us updated!

    • Ladiva04

      Hello,
      I had my surgery on the 25th of June of this year. Starting off at 117 kilos.😒
      · 1 reply
      1. NeonRaven8919

        Congrats on the surgery!

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×