Here's the Scoop on the Poop

Hi to all and thanks for your responses to my previous maniacal post of incessant rambling. Well, I spoke to Susie @ doctor's office. She called UHC and, apparently, there is an "exclusion" in our policy for WLS. I tried to review it online - no luck. Hubby's going to get booklet from office. (Would have been nice to be furnished with one a year ago!) Duh! Our fault too, I suppose. I have screamed, cried, punched, kicked, bit, cursed, cursed some more, cried some more, got a little more angry, started feeling sorry for myself...then I said "What the heck are you doing?". Ya know what? I have come too far to just give up now. I will review my policy, which I don't hold out much hope for that situation to change. But here is my silver lining folks... I am married to the most amazing, loving, nurturing, generous, understanding man in the whole world! I called him in the midst of all my hysteria and mayhem. He drove all the way home...from Southport...to calm and comfort me. (That's about an hours ride easy. Boy - I really rate, huh? hee) I can be disappointed, sure, but there is no sense getting furious with UHC. If it's not covered, it's not covered...it is what it is. But my darling husband offered this ~ He has a small inheritance coming his way in the very near future from a great aunt who passed away last year. We were going to purchase another piece of land to sit on. Instead, he offered to use some of the money to "buy me a new ass."  BWAH hahahaha! I know it sounds crude, but that's just how we talk to eachother...and he somehow knows just what to say to crack me up, even at my darkest moments. I love him dearly and I thank God for him! *sigh* So, I am not out of the running yet, my friends. I am praying to the good Lord to give me the strength to keep on fighting the fight and a strong vessel to do it in. You can't get rid of me that easy! Thank you all for your support, once again. Without you all there to lift me, it just wouldn't be the same. :O) Mary Ann PS ~ Please forgive my whining and "whoa is me-ness" from earlier. Feeling better...without the valium!

Mary Ann, You do not need to apologize one bit.  You have every right to be upset.  I would really ask your Dr. office some hard questions as to why they did not call your insurance company prior to this.  I figured that was standard procedure with Bariatric Dr.s. You are blessed to have such a wonderful husband. Hang in there girl! Lori

Yes, Lori. I feel like you do. Even though I called to find out if I was covered, they should have been the ones to follow, what I would think would be, procedure and check! They must have people that work for UHC that they talk to on a fairly regular basis, right? I usually say "everythinhg for a reason." I know I have said that to others...to them I say "sorry." 'Cuz sometimes ya just wonder...what's the reason? Maybe it's not for us to know. Thanks for your response, Mare

What a wonderful man,,,,,,, he's a keeper.   Good investment for him too!!!!!!!!!Hope you get it going soon. Now it is my turn to whin...... Myrtis

Thanks Myrtis - Yes, I have truley been blessed with a wonderful man. I think I must've earned it after my first. LOL I am kidding, of course, mostly, sort of.  :O/  No, I am. He was wonderful in his own way. (RIP Frankie Boy) And you're right. Michael knows it's a good investment. I am, after all ME! LOL He will benefit from it too. *wink wink* Things will work out one way or another. Maybe my plan is not God's plan. All in His good timing. (But I wish Him & I were on the same page.) Thanks - Mare Oh! BTW - I have you in my mailbox requesting to be my friend, but the box below only offers the "delete contact" option with no "approve friend." I will request you as my friend and see if that works.

Hi May Ann! Just replied to your original post and then saw this entry.  You DO have a wonderful husband.  Not just the footing the bill part, but I absolutely LOVE him fro coming home to be with you!  All I can say is that there is a plan and the insurance companies really have no say in that plan.  Trust the process! Suzanne

And I am committed to that plan, and dedicated to that plan, and I shall prevail! I will be victorious! *phew* Sorry...got away from myself for a second there. hee But I feel that way, kinda.  Thanks Suzanne. How are you making out? Mare

I know, it's hard when you're in the middle of the anxiety, to have faith in the process...  but I know from experience, and I bet you do too, that everything will turn out just the way it's supposed to, and that is usually FAR better than MY plans! I am doing ok, thanks.  Less than 2 weeks away!  I am on the third day of my low-carb pre-op diet and that is going swimmingly. I honestly felt that some of the insurance aspects of my process could have been better handled... and until he is done approaching me with a knife, that is all I am going to say!  lol  Read my profile and you will see what I mean. Anyway, it's all good.  Hugs to you, Mare. Suzanne

Mary Ann- I'm sorry about the exclusion with UHC- I'm hearing more and more of that! When I started this process 11/06, my BCBS had NEVER paid for a LapBand procedure. I moved along planning on self pay. By my surgery date in 2/07, BCBS was more routinely paying, but I had lost 18lbs and my BMI was now below 40%. The day before my surgery, they talked about cancelling my SELF PAY surgery to submit to BCBS. I had had the certified check in hand for 2 weeks and I was ready to roll. We did the surgery and it's the BEST $$$$ EVER SPENT!!! It's an investment in my future. I was not willing to go the insurance route, get denied, appeal the process....I was ready! I'm 40 lbs lighter now ( total of 52lbs since 11/06) and couldn't be happier. I even wonder if I appreciate and utilize the tool of WLS more. When I try to fall into old habits and consider grazing mindlessly at night - I ask WHY???? You spent this money on your health- you deserve good health and fitness. Leave the damn food alone! I have no regrets about being a self-pay. You and I are both worth the investment! Hang in there girl! Take care, Sheila

Hey Sheila - It's funny. I started out this whole process over a year ago...as a self-pay. First I researched everything very carefully 'cuz, quite frankly, it scared me a bit. Once I decided that this was right for me, I went to the bank for financing and was approved, but after thinking about it, I couldn't justify paying twice that back to bank. We had only been down here 6 months, husband just started his new job and insurance was going into effect in 90 days. 90 days? I can wait that long...no problem.  Then I met w/ surgeon...he required me to lose 30 lbs, blah blah blah. While losing that, which took me 4 months 'cuz I'm hungry alot - hee - I had my tests and nutrition and psych - now here I am, back at square one...self pay. I coulda had it done this way a year ago! *sigh* But maybe you're right. It just may work out better for me if I actually pay out of pocket, 'cuz I will "feel the burn" more if I'm a bad girl.         ie: "OUCH! That cookie just cost $50.00!!" See what I mean? Dunno...just wanna be thin, healthy & happy. Is that so much to ask? Thanks for reply. I appreciate it. Mary Ann OH! BTW - since I am apparently nowhere near my surgery date, can I bring Twinkies and Beer to the party? I don't like to share anyway... hee