New Insurance WTF!!!

I wanted to give everyone the update. My employer switched insurance as some of you already know. Well the new insurance took effect yesterday. So I called the insurance company and the new plan does not cover any surgery at all. My employer opted not to include it. My last insurance it was covered and now it is not. I don't understand why they would do this.

My mind is going 100 different directions. I wonder if they did this becasue they knew I was almost ready for the surgery. I wonder if there is anything that I can do about this or do I just have to suck it up.

I am going to call the surgeon's office tomorrow. I was hoping that maybe because my last insurance paid for the consult that they would have to pay for the surgery. I wish I could get that lucky. However at this time I am going to have to do this on my own. I mean I know that I can loss weight I have lost 31 pounds in a little less then 5 months. So I will just have to keep it up and take longer to loss it. What would you all do?? I can not offord self pay or I would.

I am hoping that when I get married that my financee's insurance will cover it. But we are about a year to year and half out from marriage we are trying to get a house.

Well sorry for this vent just had to get it off my chest. I will keep you posted on what happens. Thanks

i'm so sorry about your situation. that is so hard and really screwed up! i can't help much on the insurance front. some other ladies might be able to help you there. there may be some recourse, through your company. maybe look for another job lol! but keep up losing the weight onyour own. sounds like you are doing an awesome job. if you need any help, let any of us know. we are here for you.

Thanks Nicole for your kinds words. I am going to start my fight today to see what I can do. I am going to call the surgeon's office and see if they can help. Kind of like since the old insurance paid for the consult so they have to pay for surgery kind of thing. Then an old coworker of mine said that Maryland has a law that is if you meet the guidlines that insurance has to cover the surgery. Not sure what the rule is for that but going to look into as well. I have worked to hard to give up now. I feel like I am being tested as to how bad to do you want this. I will keep you posted as to what i find out. Thanks again.

The exact same thing happened to me. I was so mad. I was in the middle of my required 6 month dr supervised weight loss attempt when my company changed providers.   Do you know how many employees are on your insurance plan? It is true that Maryland law states that an insurance company cannot exlude it if it is medically necessary. However, as in my case, that only applies to large group coverage (51+ employees on the plan).  My company has less than 50 on the plan because most are union and have their own insurance, therefore the law did not apply.   Does your boyfriend's company offer domestic partner coverage?  I just got added on to my boyfriend's insurance that way, which does cover the surgery.   We filled out the domestic partner form May 16 and last week was told it was approved and I was added on to his coverage. I have an appointment on June 11 with the surgeon and hopefully the insurance approval will be quick.   You may try talking to your hr person and point out the fact that the new insurance excludes it. They may not even be aware of it. Mine wasn't, I got in touch with our insurance rep to see if CareFirst offered any type of rider that would cover it. CareFirst told them nope, there is no coverage offered at all. So it may not have been your employer that excluded it rather the new provider.  Hope some of this helps.  Tina

I was wondering if you and your boyfriend live together. I am engaged but we do not live together. So I did not know if we would be able to get domestic partner even if Mike's insurance does that. Just trying to get more information about that. Any that you might have would be greatly appreicated.

Kellie

Yes, we live together. I thought of that after I replied. I think we had to have been living together for 6 months, we've lived together 4 years so had that part covered  no problem.  Hopefully you'll have some luck with your doctor calling your insurance.  Dont' give up!  Have you checked out the OH insurance board to see if anyone has had a similar situation?  It was something I read there that made us ask the right questions with Dave's HR person to get me covered immediately instead of having to wait until open enrollment. Tina

Gosh, sorry to hear about your new insurance!  I know you must be mentally exhausted right now trying to figure out another way to get this surgery covered.  Whatever you do, just don't give up!  Keep us posted on what ya find out! T

Talk to the HR people at your work:  then check into the Maryland law. Most important  :  Do not give up : The  road is bumpy and often throws a curve but it is so worth it in the end

Kellie! You know the same exact thing happened to me 5 years ago.  When that happened, I did the worst thing I could have ever done.  I ate and ate and ate and I gained almost another 100 pounds!!!!!!!!!  I gave up.....and I didn't see an end to it.  DON'T DO WHAT I DID!!!!!!  Keep going with your diet and keep up with your dietician visits!!!!  Keep investigating other options if there are any.  Surely there's a loophole somewhere.....just don't give up!!!! Aaron

Did you have a written approval from them? I may be wrong, but I think that if you already had a written approval and a date that they may still be required to cover it.  Sorry that you are going through this.