Starting Over

Ailie · January 7, 2008

Well, this is a new year and I'm hoping things go more smoothly.

To make a very long story short, I went to a local seminar and filled out the application. The last week of November I got an appointment with the doctor. Come to find out, even after I spoke with someone at the insurance company, the doctor's office has had a very difficult time with my insurance company and 9 times out of 10, the insurance company (after a 6-month waiting period) will not cover the surgery. So, with one week left of open enrollment at work, I did a lot of leg work to find out if the insurance at my work (I was under my husband's policy) would cover it. You would not believe the run around I got. I called the home office of my company and the woman I spoke with didn't know enough about the insurance policy so she sent me to the website, where I got the phone number of the company. I called the company and spent 20 very frustrating minutes on the phone with them. I asked if they would cover the surgery. I was told a flat out no. Well, after several more minutes he admitted that if my primary care said it was medically necessary, then they would cover it. In the meantime, my husband calls the doctor's office to see which insurance plan they had the most success with. Even though they couldn't advise him other than to say that there have been several people who have the insurance that I was looking into and they had good luck, the woman did suggest that we call back the new insurance company and get a person's name and some kind of confirmation number from them so that if in the long run they turned the claim down, we would have some kind of back up. When my husband told me that I had to call again, I had a fit because I had all I could do with trying to pull information from people. In the long run, he called, got the information and the confirmation number (he also got a lot more information than I was able to drag out of the guy I spoke with). So, on the last day of enrollment eligibility, I signed up for the new coverage. Now, the only problem is, I have already seen the surgeon, but this new coverage is an HMO (the original insurance wasn't) which means I have to basically start from the beginning and go to my primary care...who has been out of the office for several months due to an accident. He has to send in the referral for the surgeon and so on and so on. Sigh...I'm very tired and very frustrated. But, with the coming of the new year, some things look promising with this new insurance, so once I can get into the primary, it should only be a short period of time to get the ball rolling.

Sorry...I had to vent. Thank you for listening.

greeneyez · January 7, 2008

Hi Ailie,

You can vent here, many people have gone through what you are describing. Luckily we don't have the same problems in Australia. Good luck with finding the right insurance and eventually getting your band.

Take care