rebeccamat135 2 Posted January 3, 2016 Well I found out Friday my soon to be ex husband changed medical insurances on me. I am devastated! I was supposed to have my gastric sleeve surgery on January 18th, I've been in the process since may of last year. I was in this toxic marriage for over 20 years and finally decided to stand up for myself and left and he is very bitter. I have filed paperwork with cal-pers showing that there are automatic temporary restraining orders when you file for divorce in california but my ex ignored them and changed insurance. My surgeon dr. Hiya isn't even on the new insurance he picked. Don't know even where to start all over with, I can't even afford a lawyer . Sorry.. I know I was rambling, just needed an outlet.. Share this post Link to post Share on other sites
Pinkgirl1234 761 Posted January 3, 2016 So sad...but the new insurance must have in network surgeons right? .You have to find one covered in the plan and get back on track. Don't give up...adjust and change course. Share this post Link to post Share on other sites
MillieBug 2 Posted January 3, 2016 First, make sure bariatric surgery is covered with the new company. While you're on the phone with them, you can ask them for surgeons in your area. I strongly suggest you create an account on your carrier's website and search through there. If it helps at all, Cigna covers but United Healthcare does not. Also, I wish you the best of luck in your search for a new provider! Share this post Link to post Share on other sites
Kindle 8,667 Posted January 3, 2016 Can't you just get your own insurance? Get a policy with the old company effective Jan 1. Open enrollment goes until Jan 31. Share this post Link to post Share on other sites
Mania 128 Posted January 3, 2016 First, make sure bariatric surgery is covered with the new company. While you're on the phone with them, you can ask them for surgeons in your area. I strongly suggest you create an account on your carrier's website and search through there. If it helps at all, Cigna covers but United Healthcare does not. Also, I wish you the best of luck in your search for a new provider! Ummmmm. United Healthcare does cover Bariatric surgery. It depends on what your employer (if through work) elected to have covered. My experience with UHC has been top notch and they covered everything but about $500-700 of deductibles. Share this post Link to post Share on other sites
2goldengirl 2,076 Posted January 3, 2016 You mentioned CalPERS. What sort of plan were you with, and what sort are you with now? If this is PPO, that's one thing, but if it's HMO, staying with the same medical group ought to work. Share this post Link to post Share on other sites
rebeccamat135 2 Posted January 3, 2016 I was with blue shield now with anthem blue cross,, I think its covered tomorrow I'm calling. Its just rough starting all over, I did my research and found Dr. Higa with whom I really like. Now I have to start all over with new doctor, get a referral to another bariatric surgeon. Its just a pain. And no i can't get my own insurance my insurance was with my ex, don't have a full time job. Share this post Link to post Share on other sites
2goldengirl 2,076 Posted January 4, 2016 But you didn't answer what sort of plan you have. Usually CalPERS offers Health Maintenance Organization coverage. If that's what you had, and will continue to have, then so long as you remain with the same medical group, you should be fine. Your insurance company pays for the hospital, your medical group pays your surgeon. So long as Dr. Higa is contracted with your medical group, you shouldn't have a problem. Addtionally, if you have written authorization for your surgery from Blue Shield, you may be able to get Anthem Blue Cross to honor that authorization. Don't panic. This may all work out just fine. Share this post Link to post Share on other sites
GibbsGirl 483 Posted January 4, 2016 You do have the option of carrying the insurance paying out of pocket for the month you need. It's law. I know it may be expensive but it's an option. Well I found out Friday my soon to be ex husband changed medical insurances on me. I am devastated! I was supposed to have my gastric sleeve surgery on January 18th, I've been in the process since may of last year. I was in this toxic marriage for over 20 years and finally decided to stand up for myself and left and he is very bitter. I have filed paperwork with cal-pers showing that there are automatic temporary restraining orders when you file for divorce in california but my ex ignored them and changed insurance. My surgeon dr. Hiya isn't even on the new insurance he picked. Don't know even where to start all over with, I can't even afford a lawyer . Sorry.. I know I was rambling, just needed an outlet.. Share this post Link to post Share on other sites
AvaFern 3,516 Posted January 4, 2016 Your ex violated the law...now you sue him. In many civil cases where there is a financial reward, the upfront cost for an attorney is small and they take a cut of the profits. Unless the insurance change was with his employer and he had no control over it, or unless you are now covered under a policy that has the same standard of coverage as the other one (this does not mean it covers bariatric surgery- the key components (deductible, co-pay, etc) have to be the same or better), what he did is illegal and you now go kick his a*s in court. Not only will he then be paying for your surgery out of pocket, but you can also sue him for emotional distress as well. Controlling men find that they are far less tough when a judge takes their paycheck and hands it to the woman that they tried to hurt. Share this post Link to post Share on other sites
Kindle 8,667 Posted January 4, 2016 I was with blue shield now with anthem blue cross,, I think its covered tomorrow I'm calling. Its just rough starting all over, I did my research and found Dr. Higa with whom I really like. Now I have to start all over with new doctor, get a referral to another bariatric surgeon. Its just a pain. And no i can't get my own insurance my insurance was with my ex, don't have a full time job. That's what Obamacare is for. You can get an individual policy and If you have no or little income you'll qualify for insurance assistance. It's only the middle class that makes too much that got screwed by the "Affordable" Care Act. Share this post Link to post Share on other sites
Inner Surfer Girl 12,015 Posted January 4, 2016 You've received some great advice. Related to this and any other other stunts he may pull, be sure and document everything and how it affects you negatively. You may need it in court or as you negotiate your divorce. Share this post Link to post Share on other sites
Sharon1964 2,530 Posted January 4, 2016 Dr. Higa was my surgeon. Both he and his partner, Dr. Boone, are listed as Anthem providers. You may wish to doublecheck your information. If you live in Fresno County, it is a simple matter to file an OSC - Order to Show Cause with the family court and tell the judge he changed insurance when it was not required and now your surgery is in jeopardy. Fresno County Family Court has a lot of information for people without attorneys. Share this post Link to post Share on other sites
Sharon1964 2,530 Posted January 4, 2016 (edited) Screenshot of both Higa and Boone on Anthem website: Edited January 4, 2016 by Sharon1964 Share this post Link to post Share on other sites
rebeccamat135 2 Posted January 4, 2016 Yes, I've received some great advice! Thank you everyone for helping me out. I'm going to be making a lot of phone calls tomorrow! Thanks again for helping me out while I was freaking out! Share this post Link to post Share on other sites
