Meeting with PCP...

ahh-

Sorry i have been MIA girls- My daughter got stick, then hubby, then me, the had to plan her 1st B-day....Now it is all over!!!

So I finaly made my apt. with my PCP it is on the 11th... I have been eating like crazy because i am like 3lbs shy- I am probably like 15 pounds over now! i hope i can get a referal somewhere- I am new to tricare... dont really know how the doctors with react when i ask for the referal...i hope it goes well..i am kinda nervious around it...

First time around with Dr. C everything was over the phone- i really only met him face to face on the day of my surgery...

I am in such a pickle- I can get HMSA if i go back to work for a few months- but then i have to put my kid in day care.... but i already have tricare...blaaah- I wish things were easier... I am hoping that the prize patrol will show up at my house soon then i can get my surgery...and new boobies!!

I hope everyone is doing ok- and i swear....we can livin this board up  :-)

One thing is that if you see Dr. C you won't have to weigh yourself.  Whatever you say you weigh is what you weigh.  If I am not mistaken Tricare is Military right.  Well Military will allow outside Hawaii surgery's.  HMSA is gettings strick on outside Hawaii surgerys.  I called HMSA two days ago to make sure what was covered on mine and here is the list.

1.  RNY and Lap Band only
2.  BMI >40 with a reason why. Note if surgeon just put weight loss that is not a reason.
3.  BMI 35-39 with two co-mos
4.  BMI >50 you can have a VSG.

As to my plan
1.  Insurance pays 100% of surgeon fees for opperation - not the $4500 for Dr. C or $600 for Fowler
2.  Insurance pays 100% of Anestesiologist
3.  Insurance pays 100% for surgeon assistant
4.  Insurance pays 80% for hospital stay.

I am just praying that the 20% that I have to pay is below $3000 or I have to answer to my dh.

I called tricare- and couldent even tell me if the VSG was covered... so i am just going to go for what ever i can get... we will see-

When i had my surgery with Dr. C i had HMSA- and they paid for everything but about $2200 worth of the hospital stay, and a few of the pre op tests... BUT- i was single, and making under $30,000 a year- so when i called to make a payment plan, they said i qualified to have the extra covered by something else- so i ended up only paying the $4000 for dr. c...

DH said we can do $7000- but we cant do $17000- So i will see what happens- hopefully my PCP will give me the referal! i am nervious about it- but i geuss i shouldent be, whatever happens- happens right...

we just found out that he has to go to iraq in Nov. ---- so hopefully i can get something started before then...

Hope you are having a wonderful day!

u are lucky that you get 100 % coverage...mines only covers 90%..but i guess that is better than nothing...

hi, nahea, is your insurance hmsa-ppo, or hmo? mine is hmsa-hmo, on my card it says HPH PLUS.  hopefully, mine is the same as yours.  reading your comment is the most info i've gotten about hmsa. as far as the vsg portion, i guess i qualify for that seeing how my bmi is over 60. anyway, let me know. thanx .......i really wanted dr. c, but, after doing some research i think maybe dr. fowler might be the way to go, though island hopping would be a pain in the ass as i live all the way in hilo. ugh...........and as a side note, when referring to your other half, what does dh mean? i'm assuming it means dear/darling? just wondering


jen

My medical card says:

HMO Plan: Health Plan Hawaii H-I
BC Plan 471
BS Plan 971

I hope this helps.

ah...........my BC AND BS Plan says the same thing. and knowing that you have HMO. oh, it gives me hope.    you don't live on oahu right? i been reading some of your other messages, and i thought i read something about insur paying or reimbursing part of the airplane ticket? i have since changed my mind about going w/ dr. c, and have decided that i definitely want to go w/ dr. fowler. do i call him and make an appt for consult? or does my pcp make the appt when they do a referral? sorry to keep bugging you, but since im going the same route as you, you're my closest link.  i did read about all the tests you took and about how he schedules all appts on the same day for ppl who live off island. what exactly does he do during the consult? and does he let you know that same day if he can/will do the surgery? how soon after that do you have to come back to do the tests, or can you do it where u live? so much stuff to know. i am hoping i get approved and if so that i can have my surgery by dec. or jan the latest. i appreciate all help and info you guys give me. it's so hard to talk to my friends sometimes cause even though i know they are sympathetic to what i'm going through, they have absolutely NO IDEA what it's like to be me. that's why i am so grateful to have found this website. take care!

I do live on Oahu HiGurl live on Maui she is the one that is getting reimbursed by HMSA.  Give them a call.  Its so sad that there is no surgeons on the Big Island.

I think it means dear, darling, devoted however depending on my mood it might be dam, dah, d*ckhead.  Again it is the time of the month.