A glimmer of hope

[Alexandra 55]

It seems that my surgeon's office has confidence that if I were to change insurance carriers there'd be an excellent chance of approval for a new band to replace the one removed in April. So I'm going to change effective July 1 (assuming I can talk my bosses into it, which I think I can). I was thinking about doing it anyway, since my docs are dropping out of my current network in August and with an HMO I have no out-of-network benefits. So today I'm going to be talking with my bosses about making the switch.

(Turns out there is one very good thing about being an insurance broker!! I believe in karma, and though I don't love this career I took on in 2000, if I'd done anything else I'm 100% sure I'd still be morbidly obese. In 2003 I was able to take the appeal process to the end because of my inside knowledge of the system, and since then this will be the second time I've changed carriers to follow my doctors.)

Thanks for all your support, and I'll definitely keep y'all updated!! :clap2:

[Denise 0]

Good luck to you Alexandra! Denise

[socalgal3 4]

Yay! Best of luck Alex. We are pulling for ya!

[susannah 2]

Hi Alex, That is good news. You really need this new band, it is not negotiable. I feel sorry for you all in America re the insurance situation. Here I just pay my annual premium, and I paid my surgeon $3,500 (his once off fee) and that is it. I am covered for life for fills, and any and all possible revisional surgery/replacement of the band etc, no questions asked.

Good luck with it, and work the system. Susannah

[marjon9 6]

Great news! Looking forward to hearing your progress on this new angle. And I'm sure we will also learn some things about dealing with insurance companies.

[mylapspirit 2]

Good Luck Alexandra! You are such an inspiration!

shelli

[KarenB 0]

Good luck, Alex. And don't forget the weights.

[TracyinKS 7]

You Rock!!!!!!!!!!!!!!!!!!

[Alexandra 55]

This morning I told my bosses that I really want to switch to Horizon...the conversation has begun! I'm confident that it will happen effective 7/1, and then we start the request for precert all over again.

Now I just have to get through the next month or two without GAINING!!!

[susannah 2]

Hey Alexandra, If you really keep up your exercise it will keep the pounds at bay while you wait on the insurance issue to resolve. Susannah

[momlambert 77]

Good job finding other paths to get to your desired goal--good luck! July looks like your lucky month. Karen

[jackie506 1]

I will be praying for you and keep us all posted. You are a real trooper and seeing how you push through things encourages me when I begin to fatler in my thinking. Thank you and good luck to ya!!!!

[Alexandra 55]

Thanks, y'all!! I've talked to my bosses and it seems a sure thing that I'll be changing carriers in July. So I called my surgeon's office to let them know, and to see if I can get on the schedule for sometime this summer. My NEW tentative surgery date is...August 13! This is exactly one week shy of four years from my original band placement.

Now the next hurdle is, once again, insurance approval. First I have to do the paperwork to change carriers, get it approved and get ID numbers, then have my doctor submit the request for precertification. Whew!

[momlambert 77]

August will be here before you know it--especially with all you have to do before then. Congrats on new possibilities--it looks like much more than a glimmer of hope now. Good luck! Karen

[Barbara R 0]

that is terrific news!