Mid-Atlantic insurance sucks...

Hey All, I haven't been on here in a LOOONG time. I am doing excellent: 12/27/04 will be my 4 month anniversary since WLS...I have lost 112 pounds! But my insurance has changed from AmeriHealth to Mid-Atlantic. Mid-Atlantic sucks...if you don't work for Christiana Hospital they do not cover the post op appointments. NONE OF THEM!! I am not having any problems at all--Thank God, so I talked to Irgau's office and PRMI and they both said when I get my every three month blood works done to forward them copies so they can monitor my numbers. I work at my PCP's so they will closely monitor me. But like I said I am not having any complications at all, I could not imagine it if I was!! The diagnosis they will not cover is 278.00 which is "Morbid Obesity", which of course is the diagnosis that Irgau and PRMI have to use for the post op appointments. Well I hope you are all well! Everyone have a safe and healthy Holiday! Love, Susan

Susan, Insurance in general SUCKS. Especially when it deals with us bigger folks. Maybe you could fake a pain in your what-cha-ma-call-it. They might cover aches & pains, but not the follow ups visits we desperately need to get & stay healthy, which in the long run costs them less money, DUH. I'm not a rocket scientist, but I'm saving co-pays monthly of over $125.00. So the Insurance Company must be saving lots more that they used to cover. I figure a savings of over $1200 a year in meds. Gosh I quit smoking so I'm saving a bundle there too. The biggest payoff is I'M FEELING SOOOOOOO GOOD. I think I'll plan a vacation to use up all that extra cash. Hopefully one of the people familiar with Insurance processes & procedures can give us some off the record insight. Susan know that we are all in this together. Happy Blessed Holiday to you and your family. . ((HUGS)) Elissa

I quit smoking 4 years ago...I still don't know where the money for the ciggs goes now! I hope we can figure something out...You have a very Safe & Happy Holiday!! Thanks, Susan

Susan, oh yeah, Mid-atlantic sucks. I had them originally and argued abt. WLS coverage. I finally understood that my employer had opted NOT to have it covered as a group, only Christiana. (Nonetheless, Mid-Atlantic STILL sucks) Thank goodness my husband has BCBS ... I picked that up instead. But let me tell you it was an enormous PITA even with them... I had to contact the De Insurance Commission... a long story that I will spare you. Now on to the GOOD stuff ... 112 lbs in 4 months!!! Are you serious?! OMG woman! How are you feeling? You said excellent, which is ...ummm... excellent!! I've got 24 hrs. to go before my surgery ... just 24 hrs. The clear liquid phase has me feeling a bit head-achey, but other than that I'm all about the big day!! You take care and keep up the phenomenal work! Maxi

My job kept our old insurance-AmeriHealth for one extra month just so I chould get my surgery in July. I am so thankful they did that... I just have to keep doing as well as I have been and all will be well!! Wow, 24 hours to go huh??? Good luck sweetie! You will do fine!! If you need anything at all let me know...for real! (((HUGS))) Susan

Think that is bad.. Blue Cross in Florida no longer covers GSB at all. At the convention in Washington, DC there was talk that the Blues were contemplating pulling support in 12 other states in the next two years. There is need for many of us to get extremely proactive with our state Insurance Commissioners, Govenors, and congressional leaders to press the issue and savings that the state can achieve when they look at these alternative methods for fighting obesity. Keep the faith, Rob

Rob, Please keep me posted on what I can do to help others to be able to get the second chance at life that this surgery gave me! My daughter is 7 and I know in my heart and soul that without this surgery I would not have made it to see her graduate from high school! Thank you, Susan

Susan: I know it is quite frustrating. While I was pre-op, I posted the exact same thing -- my title was "Mid Atlantic Sucks"! lol. And I AM a Christiana Care employee. It's never easy, seems like all insurances have their quirks. My post op appts are paid for, but I do sympathize with your situation. The best way to look at it is in Elissa's post--it was soooo worth it. Congrats on your amazing weight loss, and continued success. Dianne