Saying it's a journey is an understatement!
Okay, was flying high all weekend, b/c I got my approval from Ohio Medicaid. Couldn't wait till Monday to call the surgeons office. I get on the phone yesterday and call......only to be told that my approval is about as useless as the piece of paper that it is written on. Ohio is going to managed care for coverage (some areas already are). For those of us already on, we had until October 30th to pick a managed care plan. I chose mine and it picks up on Dec. 1. Well, because my managed care picks up on December 1, I quote, unquote, have a new insurance........not Medicaid. In order for my approval to be good, I need to have the surgery before November 30th. We all know THAT'S not going to happen. I would need to start from scratch and get my new insurance approval. Just so happens that this insurance needs 6 months of recent doctor supervised diet. Well, I don't have that. Although my doctor knew I was dieting it was never "prescribed" by her, nor did I do monthly weigh in's with her. It would be essentially worthless to get the new insurance to try to approve, because we only have coverage through May. Imagine my horror as I am told that I'm no further than I was 6 months ago. I was so ticked. I felt I was only granted approval, because they knew they weren't ever going to have to pay. Ironicly, I had to chose my HMO by October 30th, and that is the date my approval letter is dated for. Go figure. What to do now? Well, all is not lost and it turns out may have been for the better. See, hubby and I are on transitional medicaid. We are both working. I have been offered full time hours at work, but have been hesitant to take them, b/c I wanted this surgery so bad and more money would have put us over income. Just so happens that this week and next is open enrollment for my hubby's insurance at work. He's been working there since June, but open enrollment only happens once a year in November. We both talked, and he enrolled us yesterday with BC/BS. It picks up January 1st. We called them last night and they said all we need to do is get a certificate of insurability from Medicaid stating our family has had coverage through them for the past 18 months and my obesity will not be considered "pre-existing". They said that I can ask for approval for surgery as long as I follow their guidelines. The main one is 6 months of recent doctor supervised eating plan. I meet with my PCP on Friday to start that. I called the surgeon's office back today and have my consult on January 12 (with Dr. Lane at Wood County Center for Weight Loss). By then I will be 2 months in to my eating plan. The surgeons office also told me that if I go Medicaid to approve it, there should be no problem with BC/BS. Another plus is that THEY help try to get approval, and oh, how that makes me feel better. They know what they are doing, so I know all necessary steps will be taken. I'm going to go ahead and accept the hours at work, so even though we are paying for insurance, the income is still more. It all worked out and it's still a long way to go, because I still have to get approval again, but I have faith. Sorry to be long winded, but I wanted to share.
Tonya
You know I nix what I said before about calling. I don't want a rush job on this. Not that I wouldn't be safe in the care of this other doctor. I can't see having it by the end of Nov. viable for any doctor. I really think that everything will work out okay. It's just going to take a bit longer than first anticipated. It will be okay.
Tonya,
I am sorry that you are still having to jump through the hoops.. Please consider Dr Curry. I have heard such amazing things about him, on the boards and at the Oh Conferences. If anyone can help to make this dream a reality sooner he can do it. I have heard such good reports from everyone who has ever had WLS by him.. So give his office a call. See if they can help.
DONT GIVE UP
Laura
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