Just @#$%$#@ shoot me!!

NOT HAVING A GOOD DAY!!! Took everyone's advise and called insurance company and the woman I spoke to said that GBP is not covered by my plan. WTF? I called 3 months ago to check...before I went through all the pre-op bull****...and was told it was covered and I only had a $250 copay. So, who do I listen to? I have a call in to Susie, who handles insurance crap at my doctor's office to see if this is accurate. I have worked my fat ass off to lose the 30 lbs my doctor required me to lose, which is fine. 30 lbs for me is a huge accomplishment on its own, but I am freaking out right now! 30 lbs was do-able. It's the other 200 lbs that I just can't wrap my head around. I had a "carrot dangled in front of me" to get this far. But that carrot is so far away now I can't even see it anymore. What a bunch of horse****! Every curse word under the sun is playing over and over in my head...maybe a few new ones! Has anyone out there had this happen to them too? I have been so uplifted the past few months 'cause I saw a little glimmer of hope at the end of the tunnel. Suddenly things are pitch black. I am NOT in a good place right now. I cannot believe that with all the comorbidites I have and letters of medical necessity to have this done to SAVE MY LIFE, my insurance company won't cover it. Why do we pay to have insurance? My husband is in a job right now that he CAN'T STAND just waiting for me to have GBP. An additional $160 per week comes out of his check to pay my portion of insurance...for what?? OMG! I am rambling on and sound like a crazy person. Good thing my psych eval is done. Oy! If anyone is close by and has a prescription for valium, please come medicate me... Mary Ann

Goodness Mary Ann:      First of all take some deep breaths. So have you heard back from Susie yet? This does sound crazy and it seems like the doctor's office would have possibly known if WLS was covered or not. I am sure you were not the only one that had the insurance plan you submitted. The whole thing is crazy and I tend to think that you may have gotten someone at insurance that is not reading things right. Insurance companies are crazy. Just breathe. Maybe it is all a mix-up. Has insurance paid for all of the pre-op testing. Mine was like 4500. so it seems like if they are paying for all of those tests they know what you are trying to do, right? I don't know. Please keep us posted!!!!!!! We are here for you!

I agree, wait to hear from your Dr. office.  When you go in for your first appt., they call and check with your insurance using a procedure code before they schedule all the testing.

I would call the insurance a few times and see what answers you get. Also your hubbys HR should have benefits booklets there and you can verify if you have the benefit... also if your insurance has a website where you have online access you can (possibly) check benefits there.  Your hubby can also check if any changes have been made to the plan in the past few months via HR.  Good luck!

Do all that has been advised above plus when you call the Insurance  company ask to speak to a supervisor.  I am so sorry for your problems. Keep trying. See if you can find a coverage booklet either at dh's company or on line. I have been waiting for news since May just because of previous surgeries I am flustrated also. Myrtis

Mary~

Check your private messages....call me if you need to scream and yell and vent..

Oh Mary Ann, I am SO sorry to hear this news.  But you know what?  Nothing is written in stone except the 10 Commandments!  People make mistakes and I am betting that the person who told you WLS is not covered by your insurance made one as well.  I pray that you will hear the news you want to hear and that it will all be well with you. Suzanne

Mary Ann- When I got my denial letter my surgeons office told me that I don't have coverage. I was like, huh? I called and the surgeons office called UHC to confirm. Again, I said why would I have done all of that if I knew I wasn't covered? Crazy! So, last night I called UHC to have them explain my denial letter, which I understood completely..but my surgeons office did not? I do have coverage! How does that work? They deal with this day in...day out! Of course I shot off and email to them, they called the house while I was at work today..they usually call me cell phone. I'll be calling them tomorrow to see how they can explain themselves!

Please let me know what they say. I just can't call there to talk to anyone right now. I don't want "that side" of me to come out and ruin any chances I have to get an ally on my side. Ggggggrrrrrrrr....it's all so frustrating! Mare