Ugh! Disappointment...

I finally had decided to have weight loss surgery just recently after much deliberating. I couldn't wait until November 1st when my new insurance would kick in, and my insurance does cover the surgery. HOWEVER, I looked again at the insurance info. (United Health Care Choice Plus), and it has a maximum lifetime benefit of $5000, which is nothing. I absolutely cannot afford the remainder much of the surgery. I know the board is wrought with similar posts, but I didn't realize how poignant the feeling of utter disappointment was until I experienced it for myself. I'm half tempted to quit my job and find a job that has insurance that does cover the surgery. Half the reason I took the job was b/c the insurance covered the surgery. I just can't wait much longer to begin the process of changing my life. Yuck. I feel like I've hit a dead-end with no way out.

Rachel, You are right only those that have been thru the denile are the only ones that know how deep and disappointing it can be. I really feel for you. I dont know what kind of work u do but if u can change jobs that easily to one that covers the surgery I would suggest u do that. Then after u lose the wt u can look for your dream job with your new dream body. By then u will have so much energy u can do any job u put your mind to. Good luck in you quest. Dont give up Me

Rachel, I know how thoroughly aggravating all this can be. I was denied by MPlan initially because they didn't like the way my pcp kept his office visit notes. They did not coach him on this. Although I had done a 2.5 yr pcp supervised dieting, they wanted me to start all over for 18 months. They denied the appeal as well. I was one of the fortunate ones. I could keep my job and switch to a different insurance at the end of the year. I switched to Anthem...could not be happier! I would probably be tempted to go looking for a new job if I were you also. Keep your chin up though, stay determined, and stay positive. Things seem to come together when you least expect it. Sherri

Hi Rachel, I work for a pediatric office and one of my responsibilities is to check all the newborn's insurance benefits regarding well-child and immunizations. I just wanted to ask what the $5000 lifetime max is for? Is it the whole policy or just weight-loss related? Most policies are at least $1,000,000 lifetime max so hopefully what you saw was a typo? I would definitely question the $5000 before you give up. Hugs, Janet

Thanks for responding everyone. I was feeling pretty down yesterday, and your encouraging posts definitely helped to pick me back up a bit! Janet, the maximum benefit is $5000 for weight-loss related surgery. HOWEVER, I don't know the "in's and out's" yet, as I do not have full access to all the information until my policy starts Nov. 1st. I'm hoping against hope that it's not as stated. The "uncomfortable" part is that I JUST started this job in June, and I absolutely love it. *sigh* It's a counseling position at a residential facility for kids. I'm going to keep my eyes and ears open though, in the mean time. Oh, why do things seem so backwards in this world sometimes? I WILL keep on "fighting" though. Sometimes, I feel as if I'm fighting for life in this case. Now I know how "John Q" felt in that movie.

I would call your insurance company again and speak to a different rep and get your policy in writing. I know when I first started, the insurance compnay mmisinformed the Drs office about my coverage. They told them I had a max for $1500 and that included the surgery and hospital and everything. Turns out my company has a "weight loss assistance program" whi*****luded my dr visits, any meds, or anything like THAT towards weight loss. The surgery itself was considered just a surgery if it was medically necessary. So I had thought too that there was no way Id get surgery, but it happened. Just double check that policy! And if the $5k is it, then yeah, id look for another job. THere are always other jobs- you only get one life.

I know when I was working on my appeal and doing research, what I found out about the insurance that people have, is how the employer has certain areas set up, so it may be something that your employer has set up to only cover certain amounts. I have United Health Care Insurance also, and my surgery cost me $500 and that is only because I had to stay over night at the hospital. If it could be done as outpatient then it would have been covered 100%. I understand about loving your job, but this may be something that you want to check on, contact a rep at the insurance company and find out. I will keep you in my prayers, and hang in there. I believe if there is a will there is a way.