So sad now....

After reading Tammy's post about Aetna insurance... I called my insurance carrier (Aetna) and spoke to a very rude woman by the name of Esther. She told me that regardless that I started the necessary steps required by Dr. A and AETNA in 2004, the surgery will not be covered as it will actually incur in 2005. I dont know what else to do... I guess nothing... I dont even know if I should continue my nutrition visits at $60.00 a visit... because I will not ever be able to afford the surgery out of pocket. Beckie

Beckie - I'm sorry. Truly. There's nothing fair about it. Tammy

Beckie, I don't know how far into the proccess you are, but I would call your Dr and explain the situation. As long as you finish all the steps, maybe they could fit you on before Jan 1! It is not right that these insurance co's do this!!!! Good Luck, Carmen

I called and spoke to Lois this morning and it doesnt seem possible to get in before the first as not all of my nutrition visits will be complete.. It wouldnt be fair to everyone that completed their steps and didnt get an appointment and I did.

Who cares what is fair???? They might have ins that will cover them in 2005! This really stinks Rebecca....I honestly think this is so unfair...and the public will not tolerate this for long and they will re-instate their policy in time...but that doesn't help you now. I am so sorry. Joanie

Beckie -- I'm with Joanie -- screw fair!! Your cir****tance is special with the insurance issue, so I'd try to fight it as much as you can. We're too familiar with taking no for an answer, not wanting to assert ourselves. It's time to be your own best advocate & pull out all the stops. I'm sorry, it just sucks. But it's worth pushing a little bit. If I knew there was someone behind me who would lose the right to have the surgery because of insurance, I would want my surgery to pushed back to accommodate the special need. Good luck! Kathy F.

Hi Beckie, I am in the same boat. BC/BS is not going to cover WLS after dec. 31, 2004. Dr. A told me to write to the Insurance commissioner and make sure all the medical problems are documeted. Send him/her the letter and documentation and see what they can help. Maybe everyone whose insurance is going to stop paying should get together and write our letters and send them at the same time or find the commissioner's office and protest. What do ya think??????????? Cindy

I will write to the commissioner... and everyone in between.... It isnt right!

FYI...I just checked online for Federal BC/BS..and their 2005 brochure still states they are paying for it as long as the individual is over 18. They covred my entire surgery in July. Joanie

There are always options...I forget the name of the atty (Walter Lindstrom is ringing a bwell...but I could be wrong) who deals with wls approvals...in fact, I think there are two attys who deal with this. Don't give up. Fight the good fight, it's SO worth it. If you need a signature for a petetion...we're all up for that. Hang in there, Hun. -Deb