HELP ! HELP! HELP !

I am sooooo upset this week. Some of you know me. I am 30 yrs old, single mom of 2 kids, had my lap band surgery done 2-1-06. Did really well at 1st, but have since slowed a it in my loss, but the scale is still moving slowly but surely.... well...I have NEVER had a problem with insurance. I have approved after the 1st letter and everything. all of my fills have been covered too. My insurance has been oxford. Well my employer just informed me the package we are on is being discontinued. the new insurance will be Conniticare and they DONT cover any of this. NO FILLS, NO APPTS WITH SURGEON, NOTHING!!! I just bought a house last year and I cant afford these fills as a self pay. what the hell am I going to do now. I am a manager at my office and really like my job, I have been here for almost 10 yrs. I dont want to change my employer, but I didnt come this far to just quit now. I am just so upset by this. I am stressing out big time and I want to eat everything in sight. my boss really did try to help me with this, she looked into purchasing a "GB ryder/rider" (?) and everything. the cover none of it. I even called there myself to see if I've already had the surgery will they cover the fills. the answer was NO! Any comments/thoughts would be most appreciated. thanks, Bree

How many more fills do you need? Can you have them all done before this new insurance takes effect? Have Dr Barba give you a bigger fill each time, instead of the normal amount, so that you won't need as many in the future. Have you talked with him about this? There may be a solution on his end. Squeeky wheel... paula

definitely speak to the surgeon and get a few fills done before you lose the old insurance. I know it shouldn't be a long process til you find the right fill level and once there that's about it.....you don't have malabsorption issues like a RNY so really- once your fill level is set- there shouldn't be a lot of follow up past that. And if there is- I don't see that it should be outrageously expensive for an office visit.

Bree. How about looking into your own insurance policy instead of taking your employers? I know it may be costly but compare it to the cash you would have to hand out in fills and doctor's visits. The only other suggestion I have is to talk to your doctor's office an see if they have some Kind of payment plan where you don't need all the money up front. I am sorry you are in this situation and I too may find myself in this situation if my contract runs out in November and I don't get another job until January. I am doubled insured but my husband's insurance has a WL exclusion. Let me know how it goes. Good Luck, Nancy

Well, a couple of things come to mind- First- your surgical follow ups should be convered, regardless. medically necessary post-op surgical followup should be covered, regardless of what insurance actually paid for the surgery. It has something to do with pre-existing conditions and continouous insurance coverage. I believe that by state law, the new company is required to provide some coverage. Speak to your HR person further an possibly the company insurance rep, NOT a phone rep. Don't talk so much about the type of surgery as much as the coverage medically necessary surgical follow up from a pre-existing condition. I had a different insurnace when I had surgery than I do now, and they pay for my surgical followups, including testing, no questions. I co-pay, of course, as required. It has nothing to do with gastric bypass, which my insurance no longer covers. That's a done deal. I now have surgical followup and testing needs that deal with my general health and well being and the insurance pays for them. That's that. So, please don't take NO for a answer on this issue. However, the fills will probably never be covered. As, I daresay, they will never be considered medically necessary. I've heard fills aren't THAT expensive- a couple hundred bucks or so is what I'm thinking was the quote I had heard. You can def. manage the fills w/your Surgeon so that they are unnecassarily happening too often. Speak to your surgeon about this right away and get working on a plan to mitigate your costs. I trust you'll find a way to manage your budget in order to honor your commitment to this lifelong process. You may have to look very creatively at your budget, but I'm sure you can mange it. Perhap even speak to a financial advisor to get some assistance if necessary. I know it smarts when life sends you an unexpected curve in the finances. Been there, done that, probably do it over again sometime soon! But, have faith and be positive and creative in your thinking. Where there is a will there is a way. Best, Lisa C

Bree: (snorts) Welcome to the wonderful world of Connecticare. They suck. We just had our rates upped out the wazoo last year with them and they don't cover s**t, which is what their "coverage" is. God help you if you need a test. With OUR "coverage", a colonoscopy is a FIVE HUNDRED DOLLAR copay. Nothing like being anally gouged TWICE. I second the suggestion that you speak to your surgeon and see if you and he can work something out. Bette

Hey Bette You look Great with your bath suit Hope you will come to Walk for Obesity because I heard so much about you from your gangs! Hugs Kathy K

"Gang"? I don't have a "gang." I've been left to fend for myself.

Get out of freaking town, Bette!!!! Look at that pic in the bathing suit- holy shamoley- are you ever the poster child for Lap Banding or what??? Bree- I agree with Lisa C- do whatever you have to do to maintain your new lifestyle. Hell I am looking for a 2nd job right now so I can begin digging out of the credit card hole I am in and hopefully have PS next year.....do I want to pick up more work? Hell no- but Ineed the cash. So I do it. The pre-existing condition thinghie in the law- Lisa is right- I was hospitalized in May - not for complications of surgery- but those had to be ruled out- there are tests bloodwork and procedures I went thru (CT scan) that had I not had a RNY wouldn't be needed- but the insurance covered them just the same- so if GOD FORBID- you need follow up care other than a fill it should be covered- the fills themselves - as I have been told- range from $150-$300- I think your surgeon is the lower number from what someone else said. Ya gotta do what you gotta do to maintain. Hell if you end up looking like Bette, it;s worth it!!!!!

Hey Bree, First off, Relax!! I agree with all these folks! Talk with your Doctor, Know he will help out any way he can to keep you on the right track. I am sure he wil work something out with you! Thank goodness you already had the surgery!! That was the important part! I have Conneticare and they have been great. Ok'd my" Panni" first shot. Same for my Bypass surgery. Glad I'm having all my work done before the end of the year when everything gets renewed. You just try to take it easy, you have come so far and have done so well. Can't let this undo all the good that has already been accomplished! Take Care,