Insurance Mess! :-/

[NewLeaf15 20]

Hello,

I'm hoping for some positive vibes.. Here's my situation... I work for a managed hotel company, and the old management company returned us to the bank and a new management company came in.. Unfortunately my luck, the old company agreed to pay Cigna premium through October 31st and my last nutritional appointment is Monday, November 2nd. The new company looked for a new insurance for us but it's "individual" and not a company "group" insurance through United Healthcare. I called the number they provided and they said bariatric surgery is not covered since it's an individual plan. I looked at Cobra and it's $738 per month. Yes, nauseating. I called Cobra and Cigna and they said I would still be covered if I Cobra. After calling all insurance and getting it cleared, I decided to Cobra. I wrote a check today for $1476 to cover me through December. Thankfully I can pull that from my savings. Everyone at my job is freaking out about the insurance because the United Healthcare policy is extremely high and barely covers anything.

I then called the bariatric center and I told her the information and thankfully they've been super helpful. They said as soon as I come in next Monday for my last nut appointment that they would submit that Tuesday so we can move the process quickly. She said if all goes well, the surgery would be about the 2nd week of December if Cigna approves within the time frame they usually do and they don't bounce back the paperwork.

I just have a lot of anxiety with this insurance. It's like I'm almost there but I keep getting pulled back. My mother said it will all work out. I just need to stay positive.

Has anyone else gone through a cobra situation?

Thank you!

[2goldengirl 2,076]

Your mom is right

You've paid your COBRA up front, which helps. Sometimes there can be a blip on the radar when your group plan changes to COBRA - there is an end date for the group policy and a start date for the COBRA policy. Your ID number shouldn't change, just your group number. Your surgeon's office knows what you're doing so they won't get fazed over any blips in eligibility. The hospital may do an eligibility check when you check in day of surgery, so make sure you have the new card with the new group number on it & you should be fine.

There is a 90-day "global period" following surgery so postop visits during that timeframe by the globl fee your surgeon gets. You may want to have their office check with Cigna about that just to be sure.

And if you itemize deductions, your tax person may advise you to deduct the cost of your COBRA payments.

Good luck, and I hope this helps!

[NewLeaf15 20]

Your mom is right

You've paid your COBRA up front, which helps. Sometimes there can be a blip on the radar when your group plan changes to COBRA - there is an end date for the group policy and a start date for the COBRA policy. Your ID number shouldn't change, just your group number. Your surgeon's office knows what you're doing so they won't get fazed over any blips in eligibility. The hospital may do an eligibility check when you check in day of surgery, so make sure you have the new card with the new group number on it & you should be fine.

There is a 90-day "global period" following surgery so postop visits during that timeframe by the globl fee your surgeon gets. You may want to have their office check with Cigna about that just to be sure.

And if you itemize deductions, your tax person may advise you to deduct the cost of your COBRA payments.

Good luck, and I hope this helps!

Thank you so much for the information you provided! I actually didn't know I would get a new card. I thought everything would stay the same and I would use the same Cigna card. Once they process my check I will give them a call and see if they can forward the new card to me. I want to ensure I have all my T's crossed and i's dotted during these process.

As for the 90 day global fees you mentioned, I Google'd the information.. Correct me if I'm wrong, but any follow up after the procedure would require additional fees? Did I understand that correctly.

As for tax write-off, I did hear that from someone and hopefully I'm able to do that.

Thank you again. Hopefully if all goes well it would be for December.

[The Candidate 3,215]

You've certainly had a lot on your shoulders, but I'm glad it worked out in the end.

I haven't had experience with Cobra, but one of my Kaiser classmates did. She ended up being laid off and losing her coverage like a week after we graduated from the six month classes. Kaiser worked with her to fast track her through the rest of the program, and she was able to get the coverage continued through Cobra to go on and have the surgery. It worked out well for her.

Best of luck to you!

[Sharon1964 2,530]

As for the 90 day global fees you mentioned, I Google'd the information.. Correct me if I'm wrong, but any follow up after the procedure would require additional fees? Did I understand that correctly.

Not necessarily. Every surgical procedure has a global period, where all normal care is included in the fee for the surgery. The only time you would have to pay would be for followup care that is not normal - meaning complications. Minor complications are included; major ones are usually not.

[NewLeaf15 20]

Sharon1964 - Thank you for clarifying that for me!