Update on my insurance drama

[MyTurn 0]

So, I just got off the phone with my surgeons office. He unfortunately isn't contracted with Blue Shield and does not accept it, meaning that I would have to pay out of pocket. So, I guess me being banded isn't going to happen right now since I cannot afford the amount of money it would cost being that I am a single parent with a child in college. It figures.

[Wheetsin 714]

Surely there's more than one surgeon to select from, and one of them is a network provider...?

[MyTurn 0]

I am guessing that there must be. It's just frustrating to be almost done jumping through all the hoops that one insurance company needed and become comfortable and very happy with my doctor, to having to think of having to start all over at the very beginning. I am sure that anyone that has had to go to appointment after appointment after appointment to get a surgery that can save our lives understands the frustration. I have been in the process of this for months and then to have it just taken away from me when I am only weeks away from my surgery is just upsetting.

[nicegirlnw 0]

I sort of went through something similar. I thought I would go through a certain doctor and center. However, I later found out that they were not in network for my insurance. I just called up my insurance which happens to be Blue Shield Regence. You ask them for names of Lap band surgeons and they should be able to provide you a list of possible doctors. I would try to go to lap band specializing center if that is possible. Since they are so familiar with the process of getting approval for surgery. Hope that helps :redface:.

[make33 2]

When considering the surgery, the first two things a person should do is (1) investigate what your new life will be like and ask yourself whether you can make the necessary adjustments for it and (2) if you have insurance, go to the insurance website or your provider directory to check if they cover the surgery and investigate where the Bariatric Centers are that are approved by your insurer.

They only approve certain doctors and it's their money. So, my advice to you is to pick up the pieces, make sure the insurance WILL cover the surgery and start over again with the approved doctors. Count this time lost as a well learned lesson.

Believe me, it will be well worth it...

[MyTurn 0]

'They only approve certain doctors and it's their money. So, my advice to you is to pick up the pieces, make sure the insurance WILL cover the surgery and start over again with the approved doctors. Count this time lost as a well learned lesson.

Believe me, it will be well worth it...'

Thanks for all the advice I really appreciate each of your replies. Although, I am not sure exactly what lesson I could have learned from this as I did follow all of my insurance requirements, they were going to cover the surgery and the doctor and the hospital were in network and approved by my insurance. The fact that my company decided to change insurers had nothing whatsoever to do with me as they just decided that they wanted a better rate on their premiums. It just so happened to fall smack dab in the middle of my lengthy Quest for weight loss surgery.

Edited April 11, 2008 by alexbaby16

[kristylyn 0]

I can understand what you are going threw. That happen to me a while back. I was getting everything done for my surgery, had surgery date set and everything and then next thing I was cut off cause we got a new insurance company and then the new ones didn't cover the surgery at all..So I was so MAD and now I was stuck with all these bills and I got nothing done.

Don't give up, if this is what you really want to get done to you, then just start all over and find out if this insurance covers it and if so then find a Dr that does it. I know it's rough starting over, but sometimes that's what we have to do to get great results. I did and now on April 14 2008 I am having mine done. The Dr that is doing mine, isn't one of my Drs, HE is a surgent that does the lapband and he is really good and really the only one who does it in my town. So that is the only advice I can give you is to keep your chin up high and if you really want the lapband, then you have to roll up your sleves and start all over. Who knows you might succeed...Take care!!

Kristy

[Angie4b1g 1]

They've knocked you down, but all you gotta do is get back up and try again!

I never had the option of insurance covering my operation. I wish they would have, I'd have done whatever they wanted to save myself that $13k!

[Birscholz 0]

If banding is an approved benefit you will have to go with a doctor the Insurance approves. Just do your homework and don't give up. You might have to go with somebody else.

[mae 0]

Yes, Don't give up. I have BCBS of MI and they will not give pre-approval for surgery. The doctor's office has to be on top of everything and do all that is required of the insurance company and make darn sure I have fulfilled the requirements. Other patients at my support group also have this insurance and said not to worry. Our Dr. Verseman is very aware of the insurance companies and have had no denials. I hope so otherwise I will be paying for this outright for a very long time on a charge card. I need this surgery and will do anything it takes to get it.

Good luck to you.