My journey is over........and it had just started

I am so upset I can barley see throgh the tears,,,,,,I have Wellmark blue cross/blue shield alliant select ins. through my dh work. I have seen the diaticion (sp) and had my pysh. eval already and today am suppose to meet with my surgeon today at 2:00 pm. Yesterday in the mail we get a new benifits book and a letter from the ins. stating that there had a miss print in the book that was given out in Jan. Wls is NOT covered as of last Jan 1, 2004! What gets me is they just now after over 6 months saying it was a miss print? I have been upset and crying since yesterday and my dh is beside himself. It doesn't help that he keeps saying to me "I'm sorry but we can"t afford to pay for wls." I don't think it would be quite so bad if I weighed 250 lbs but I weigh over 460 lbs. This was a lifeline to me and my last hope to get to feel better and to get off my 8 pills a day that I take. I have sleep apnea, high B/P, major depression, incontinence, my legs swell up 3x the normal size, back pain, knee pain. I am unable to walk very far as I get winded and my back hurts. Well I have always known that Ins. companys would rather you died instead of them having to pay to help you. I told my dh to send a thankyou card with my obituary in it to them. Its just a matter of time now , I have given up all hope.

Cynthia, Please do not give up hope...contact your local Vocational Rehab. center...they have been known to pay for this surgery 100% many times over. I am assuming, due to your weight and your health problems and numerous medications, you should have no problems being approved...just more hoops to go through. If you are not working, apply for Disability benefits, as well...Medicare has just 'officially' recognized obesity as a disease...based upon your income, you may even qualify for Medicaid immediately, even if you need to wait for Disability and Medicare to kick in...Medicaid pays for RNY 100%, too. Please do not give up hope...when one door closes, another opens...we sometimes just need to search in the dark for a while before we find it. Call your local Voc. Rehab. office this morning and get the ball rolling, OK? (((Hugs))) Sherry Open RNY 02/04/04 (Proximal-75 cm) 294.5/208.5/150 -86#

Cynthia, I just put your post on the main message board...I hope that you do not mind. I was hoping to get some responses from those that have gone through Voc. Rehab. and to get them in contact with you...I know that there are many out there that have. Again, I hope that this does not upset you...my heart hurts for you, and I don't want to see ANYONE give up on hope. & ~~Sherry

Cynthia, Hang in there and try and fight it! Sometimes people need to try and overturn the ruling of the insurance company. I have had friends who have still been able to have surgery even when the insurance said they will not cover it. Be Persistant! (((Hugs))) Vonnie

Cynthia, Please don't stop fighting!! I think Sheryl is right. It may take more time, but it may not be impossible. If you're unable to work and have been for at least a year, you could try to qualify for disability? Is there other insurance offered through your hubby's work - does that coverage allow WLS? What about private health insurance for just you? Could you afford a policy for just yourself that might cover WLS? Is it possible you could talk to a lawyer that specializes in these cases. Maybe a letter or two from him could convince BC/BS that it was they're typo and you shouldn't have to accept it! There are POSSIBILITIES!! You're just going to have to be your own advocate! And think about it - even if it takes another year or so, you could still be better off in the long run than if you do NOTHING. If you do what you can right now - working with your nutritionist and so forth - you might be able between now and surgery to lose enough to have the surgery done Lap instead of Open? At least you would be able to tell yourself you've done EVERYTHING possible. I know it's going to be hard but don't lose hope!! Please don't! ((((((((HUGS))))))))) Take care, my dear. Let us know how you're doing! -Deb W.

I have BC/BS alliance selectand they approved me in Jan. I just had the surgery in May You have a great chance with all your health risks. Fight it....If you have a strong Dr. to back you up and push for you, you can do it. Please don't just give up an let them win....The ins. companies already have so much power. If everybody listens to them and doesn't fight, we are just giving them more power. Keep pushing...you deserve to keep fighting. You are worth it. If I can help in anyway...please let me know, Tammy

This really makes me mad. Please don't give up hope! I know there is a way for this to happen for you. You will get all kinds of help and information from the people here on the boards! TTFN ((((((((((((((((Hug)))))))))))))))) Jackie

Cynthia..... I am so sorry you are having such a hard time with the insurance. I would fight this tooth and nail. Call your doctor tell him what you found out - get his team involved and have them write letters. Call the insurance company and fight. They can't wait until it is almost time for the new benefits to come out to update this years. You can't give up - you have to fight not just for your dh or your family or even us... but for you and the person inside that has been wanting to come out for a long time. I work in surgery and I have seen many wls pts come through on Medicade - contact them and see if they can help. Most of all don't forget to pray and pray some more. I know that is why I was able to get where I am now because of God. Keep positive feelings in your heart and mind - the only reason most people don't succeed is because they didn't have faith! God Bless - Keep us posted and let us know if we can do anything. P.S. You might go personally see the geeks at the insurance company. I would think it is rather hard to tell someone to their face that they won't help. You're in my prayers.... Melinda