Why ohhh Why?????

Can anyone please tell me that there is life after you get the rug pulled out from under...sorry feeling dramatic ....I have been planning my surgery for what seems like forever, paid all the HUGE anthem co-pays,ect. and finally was set to go for Feb......and my company switched our insurnce to Oxford with an exclusion clause (that takes effect Feb 1st)......has anyone else dealt with this as I am so disheartened I could cry.....EVERYONE at work knows I am planning to do this, thye have supported me 100% thru the fun week of prottein and water and have geared me up for the surgery and the new me, how do I go about fighting and winning this kind of battle? I am UNFORTUAntely a HEALTHY obese person...no HTN,GERD,APNEa,ect just 300+pounds of excess that I run around with daily...okay done rambling...please excuse the self-pity, and I appreciate any and all comments...thanks Dreajavascript:setMainIcon('confused',15,22)

Are you saying that the new plan takes effect Feb 1st or just the exclusion plan? If you still have coverage til Feb 1st why can't your doctor get it done by then??? Sorry to hear this- I am sure you aren't the first one to have something like this happen, the Ins. problem is a growing one- with exclusion being the norm now- however many plans have riders, and I encourage you to "chat" with human resources about this

thanks for your responses, clarification: I can not get in before Feb 1st, called and asked , was told in no-uncertain terms NO, all docs are booked solid. also the new insurances (3 were offered) all have the bypass EXCLUDED...part of a MEHIP plan we have to use as a non-profit in CT. I am going to see if the band is also in this exclusion , hopefully not...I will gladly adjust my plans to the band....my boss would be happier...back to work sooner.Unfortuantely have talked to my HR person, we have been a SUPER liberal company up until they hired a new finace guy, now we are run like a huge hospital and not the small psych based homecare company we are. So, the journey continues...thanks again!!!!!

I AM SO SORRY TO HEAR THIS! CAN YOU MOVE UP THE DATE? THAT SEEM LIKE YOUR LIVE SAVER RIGHT NOW. GOOD LUCK AND KEEP US POSTED. BLESSINGS SPLENDALICIOUS

Hi Andrea, I am sorry to hear that you are having such a hard time. I am questioning why Oxford won't pay for your surgery??? I have Oxford and they have been great about everything so far. I have not have to pay anything accept my co-pays. Coincidently enough, my surgery date is Feb 1st. Let me know how you got that info. I have my approval letter and I am all good to go. Think positive. Bree

so sorry to hear that. did you try all the doctors at st. Raphaels? None could squeeze you in? If you have all your pre op stuff done (ex: nut. psy. evaluation, 5 day diet) Did you get the o.k. from your current insurance carrier? maybe there will be a cancelation and you could go in. But you should call all the doctors in the building. Don't depend on one office to give you the infor. for all the other doctors. do it yourself. Valin, Rhinehalt and the rest ... maybe one will have a cancelation. For me from first infomational meeting to surgery was one month. I pushed to get it done as fast as I could because I was afraid of the same thing with our insurance and the doctors understand that so they helped expidate it. good luck.

Andrea, From your posts, it seems that the bypass is excluded as your employer does not want to pay extra, so they opted to remove this section for a better coverage contract. From what I understand, you can have this put back on your coverage by paying extra for it, which will increase your premium. I work at Hartford Hospital and Connecticare offered the same deal for a cheaper contract, but since HH now does the WLS, they could not exclude this from their contract. Check again with Human resources to see if you can pay extra to have the WLS covered under your plan. Debbie

Hi Andrea, I am in the same boat you are in. Unfortuately my insurance which is Connecticare renewed itself August 2005 and when it did there was an exclusion on the policy now. I had finished my preop stuff in June. I have been going thru the insurance comissioner she is very nice and the last I heard she saw my dad at a political function and told him that she was working diligently on this process of trying to get me grandfathered in for the insurance she is very upset about this whole dilema it's very sad I came so close but yet so far away. I just want to be healthy again I am very depressed because I just feel like it will never happen for me. I can't afford to pay out of pocket for it. And why should I have to pay out of pocket when I pay out enough money for my insurance. There is alot of people that are in this boat. I just can't stand this anymore, unfortuately I have gained 10 pounds in the last 4 months. My surgery was suppose to be 10-24-05. Good Luck!!! Sorry for venting! Hydie L

Hi, I'm from North Carolina, but I read other state's pages. I had sort of the same problem as you. I had gone through all of my testing and had my paperwork sent into the insurance company the same day I found out that as of 1/1/06 our insurance wouldn't be covering this surgery anymore. Just like you, I called my doctor and was told none too nicely that he was booked solid and they couldn't help me. I felt like I had hit a brick wall. I went into a major depression that first day, then I went into fight mode. I started calling and calling - here in Charlotte, then surrounding areas. I found a doctor about 4 hours from here who had an opening, I went the next day and they scheduled my surgery for December 28, 2005. This all happened on December 16, 2005. DON'T GIVE UP - THIS IS TOO IMPORTANT. I knew this would be my only chance to have this done and I was going to fight. I got on first name basis with our HR director and she pushed it on through. I feel so blessed, but I was so worn out mentally. Please keep trying - its so totally worth it! Good luck! Crystal