Can the insurance company manipulate dates to avoid paying 100%

[sunnkistme 76]

I have been thinking about surgery for years but always felt it was soooo expensive and my weight wasn't THAT bad. After a lifetime of obesity this year it got THAT bad. I decided that this was the year to make a change. I will end my 6 months supervised diet in October. My BMI is 39.5 to 40.2 usually. Each calendar year between copays and deductables, I have to pay 8000.00 out of pocket at which point my insurance covers 100%. For the first time ever, I will be about at 100% by August. I can not come up with 8000.00 again next year if they successfully put me off until 2015. Has anyone had experience with this situation.Now that I am determined to have WLS the what if's are making me worried.

[NICU-RN 31]

It isn't the insurance you need to worry about - keep on top of your surgeon's office to get the surgery scheduled in a timely manner. My insurance didn't delay, but my surgeon's office dropped the ball and I got put off until just after the new year so deductible and co-pay's kicked back in on me. I was majorly ticked at my surgeon's office "case manager" but that is another story. I just strongly encourage you to keep on top of the surgeon's office and insurance if you need to - but I really think the problem if you have one will be the office and not the insurance company.

Edited May 30, 2014 by NICU-RN

[sunnkistme 76]

Thanks for the input. I had not thought the surgeons office would or could be a problem.