Stupid reps at insurance company

[kaytiebugs 0]

I know no one really wants to hear a cry baby, but I need to vent.

So, in the beginning when I was filling out my 800 page application (after the seminar) one of the requirements was to call my insurance and get my benefits details.

Apparently I spoke with the town idiot. She told me that my bariatric deductible was $1,500 and I was responsible for 20% of everything after that UP TO my $2,000 annual MAX out of pocket. So.... here I've been thinking I only needed $2,000 for months now.

Well things are getting close to wrapping up and I was talking to one of the nurses at the surgeons office, just making sure I understood the financial part completely. She said that didn't sound right and it looked like my expense was going to be $3,500. The $2,000 was ONLY for my 20% and the $1,500 would be ON TOP OF that amount... so $3,500 total.

I just called to verify and she's right.

Holy effin cow. It just seems like one thing after another, as if God just really doesn't want me to have this surgery. I was SO FRIGGIN CLOSE. Everything was about to be submitted (and will still be submitted) and I would have a date soon! Now I have to magically come up with another $1,500!!! Not flippin possible.

I applied for financing.... got denied.

It'll just have to wait EVEN LONGER. My hubby gets a student loan check in late Dec/Early Jan and we'll use that.... but no one seems to understand how it feels to have to wait EVEN LONGER!!! I've been working on this crap since JULY!! I started researching in MARCH and decided to start looking at doctors in JUNE!!! So I've already been hoping and dreaming for so flippin long. Now I have to wait even longer.

I seriously just want to go home from work right now. I've been crying half the morning. No one understands how emotional this whole process is... or the sense of desperation and feeling of hopelessness.

[itsallaboutMEb 0]

I think alot of us understand the desperation here. I have never been so anxious and nervous for somthing in my entire life...trust me its hard as hell to wait and wait and wait more for phone calls, letters... then to feel like an idiot cuz you keep calling the drs office so much. Im exhausted from all the work i have had to do to finally get approved and i still feel uneasy like somone is gonna take back their approval. But in the end of all of this for both of us its soooo gonna be worth it! Good luck and stay stong!

[newimage 2]

Katiebugs,

I'm sorry you have to go thru this. I'm even more sorry you had to speak to an idiot.The insurance reps need to understand that information on such procedures need to be accurate. I will have you in my thoughts and prayers. Don't give up! Hang in here.

[RestlessMonkey 7]

Can't you just pay the deductible and them bill you for the balance? I had 2 surgeries in August and haven't even got the hospital bill yet!

[kaytiebugs 0]

I asked them... they said no. The surgeon requires payment up front, and the hospital's primary business is bariatrics, they require payment up front too.

Frankly.... I don't blame them. I work in a medical billing office and know what it's like to try to get someone to pay something they owe. I wouldn't want to hand out free services if I were a hospital or surgeon either.

Also, bariatrics is a little different... almost all docs require payment up front. When you are sick and need your appendix removed before it ruptures and nearly kills you, the situation is a little different.... you don't have time to save and you legitimately need to have the surgery right then.

Can't you just pay the deductible and them bill you for the balance? I had 2 surgeries in August and haven't even got the hospital bill yet!

[RestlessMonkey 7]

Ok just trying to help. I have always paid my bills on time and assumed you would too. Just wanted you to know I did NOT mean to imply that you could get out of paying the bill. Personally I've got cash ready for when the hospital bills me; I had thought I'd be self pay, so I'm kind of in a reverse situation from yours. They didn't make me pay anything up front except my $150 deductible. I'll owe around 1500 when they get around to billing me for it; since they didn't ask me to pay up front for my bariatric surgery, I'd hoped that a similar situation for you might give you time to gather the funds. Sorry if I made it sound like you should not pay; that was never my intention. That's stealing.

[jczmyjoy 0]

Katiebugs, don't give up! I started all my paper work in March and fought with the insurance company for months. Like you, I began if this was what God really wanted me to do. It seemed like every door was closing. I can't tell you how many hours I have spent on the phone with them! They finally approved it. I had my first Dr appointment the first of September and was banded on October 1st. Was the ball got going it was really fast! Just don't give up. If God wants this (and He does want us healthy!) He'll provide the money! Short story: Once we had a bill due and didn't know where we were gonna get the money to pay it. It was looking bad. My husband went to the mailbox and there was a refund check where we had somehow over paid a bill to somewhere else. What was so amazing about it was that it was to the penny the amount we needed to pay our other bill! I'm not saying this is going to happen for you but who knows! God works in mysterious ways! Good luck to you!

[MacMadame 81]

I think "stupid insurance reps" is redundant. :wink2:

I had one tell me WLS was included in my policy when it was excluded. In fact, that happened with two different reps at two of the insurance companies my company uses. Morons.

[sunflwr78 0]

Keep your head up...Everything will work out for you in the long run. Dealing with insurance companies can be extremely difficult. I am dealing with Tricare right now. I found out last night that they have my surgeon listed as Out-of-network (when he is clearly in-network). Because of this they referred me to someone who I won't be able to see until sometime next year. I wanted to tell them, "Hello crazy people. I wouldn't have asked for a referral for a out-of-network doc" gggrrrr!:wink2:

[MiniBand 0]

I am just waiting for approval but at first I was really upset about all this stuff (waiting and waiting at the mercy of the "morons") and then I got denied. I decided not fret about it and just keep making positive life changes. This is working. I am exercising more and watching what I eat and to be honest I am feeling better than I ever have. Once I let go, it all seemed to kind of make sense. I do know what it is like to want to something so badly and it not happen. It nearly drove me mad. Don't do this to yourself. Keep making positive changes. Remember the band is a tool, and right now you have other tools to work with. I am going through the appeal process and I am not obsessing too much about that and things are falling into place for me. Just keep as much faith as you can and hopefully you'll have some peace.

Hugs,

M

[Wheetsin 714]

Put it on a credit card? $1500 is not that much in the big picture. I know if you don't have it, it's the world, but maybe some out of the box thinking can help? If you can get a ~5% APR card, you could pay about $150/month and have it paid off in about a year. Pursue other financing? $1500 is not a huge amount to get, even most retail stores approve that much without very strict requirements. I don't know what avenues you tried, but if you tried medical financing, try personal or vice versa. Anyone you know to borrow from? Any med assist benefits at work? Anything you have that you can sell? (I know more than one person who funded their surgeries using hobbies, unneeded tangibles, etc.) Something you coud postpone 3 mos and use tax refund monies (assuming you're in a positive position) to help with, or pay off whatever loan you might be able to get early?

Just some thoughts, best of luck.