I'm not sure if this is t...

Katie H.
on 6/20/03 9:02 pm - Charlton, MA
I'm not sure if this is the right place for this, but maybe someone will have more of a clue than I do about it. Okay, my pcp thinks the surgery is a great idea and supports me in it, but I don't have the best health insurance because I do volunteer work through americorps. I'm not sure if it's covered, so I was just going to get all my tests and stuff done and then see if it was covered when the claim was submitted, but my pcp thinks i should call and see if it's covered. is there a way to see if they cover it w/o letting them know who i am, so they can't deny me in the future, or is that a dumb question? and if it's not covered, is there anyway i can get like a list from the doctor to see how much this whole deal will cost? should i just call the surgeon's office for that? any help will be greatly appriciated!!! thanks!!
Liza B.
on 6/21/03 1:14 am - Ansonia, ct
Katie~ I wouldn't worry about calling your insurer, but if you are worried I would call anonymously and just say you wanted to find out if the carrier covers gastric bypass surgery. They should be able to give you some general information. If your insurer doesn't cover you and you have to look for other mean, there is always financing. Some surgeons work with financing companies. Or you can contact some companies that do medical financing. Here's what I've found so far in reference to financing: Cosmetic Fee Plan by Capital One, 1-888-440-2375 and Medicredit.com, 800-963-6334. Or if you have a home you could take a loan on the house. Just some ideas. Muah!
LMCLILLY
on 6/23/03 4:23 am - Central, CT
I agree with Liza. Call anonomously, if you are worried. However, calling and asking a question will not make them deny you in the future. You pay for their service and are entitled to ask the questions you have. The other option is to request a plan outline in writing. It's a big book that lists what/how they cover everything. You are entitled to one. Mine clearly stated surgery for obesity if medically necessary was covered. I called too, just to make sure and got the codes for the procedures that they cover and gave it to my surgeon. You can ask for the codes too. I know it's nerve wracking to deal with insurance, but just remember, be polite, be freindly, if necessary, be firm and when necessary be insistent. But, always be nice. It will move mountains for you with grumpy customer service reps. Good luck!!
Katie H.
on 6/27/03 12:27 pm - Charlton, MA
thanks so much!! i'm calling first thing on monday, hopefully all goes well! ~katie
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