end of year surgery and insurance coverage

[abtenney419 13]

I feel like this entire pre-op process has fried my brain. Literally, things that prior to this I would just say "Let me look this up" or "I will call the doctor" or whatever are now causing me all kinds of distress and second-guessing...I think it's because I have been working really hard to make this happen and I want it so badly that I've convinced myself it will all fall apart at the last minute!

Here's my question: my surgery will most likely be scheduled for mid- to late December, according to my patient navigator. But say I get everything done, get the approval from the insurance company, and for whatever reason can't get the surgery scheduled until early 2016...is the approval still valid? Do all the pre-op tests/labs/etc still "count"?

Or would I at that point have to basically start over?

Help!

[The Candidate 3,215]

I can't really help with the insurance question, as I only had a co pay that would have been the same going into the next year. My approval, I was told was good for a year.

But I can definitely relate with the mind thing. I can't tell you how many far fetched scenarios I dreamed up in my head as to how they could deny my surgery. Good news, it was all for naught. Yet I nearly drove myself crazy!

Good luck!

[Inner Surfer Girl 12,015]

This is a good question to ask your insurance coordinator.

I would THINK, based on my experience that the clearances and approvals are for a set amount of time, i.e., six months, as opposed to an arbitrary calendar date.

[Sharon1964 2,530]

Your authorization will have a "valid from" and "valid to" date on it. Should it be 30 days, for example, and you cannot get it done within that time frame, it usually only takes a phone call to get the auth extended.

[2goldengirl 2,076]

The only time a new calendar year might trip you up is if the renewal date for your insurance happens on Jan. 1 AND there is a significant change in your coverage, OR if you have a deductible that rolls to zero every Jan. 1.

For example, a lot of people have coverage that changes on Jan. 1 - I've had folks whose employer were changing health plans. In those cases, weveryone knew about the change ahead of time and we made sure everything got wrapped up before the change.

Other folks are madly trying to get things done and scheduled before the end of the year because their annual deductible starts on Jan. 1.

Hope this helps!

[newmebithebypass 713]

i work in insurance so i can answer your question usually authorisations are good for a amount of days say 30 60 or 90 days so if you got your approval say december 12 it would be good 90 days from that date. the surgical clearnaces i work with are usually good for 6 months at a time and blood work is usually good for 1-3 months at a time hope this helps

[abtenney419 13]

Thanks - I appreciate you all taking some time out to offer your input

[ladytqueenb@gmail.com 0]

Hey everyone I need to ask a question. I'm trying to have the GASTIC sleeve done next year in February but that will start my deductible over. So can I get approve this year and just set my date for 2016 that way I don't have to start over with my deductible?