Pacificare members? We NEED your opinion

Okay, as we all know, Pacificare has terminated Dr. Floyd's contract as of October 15th. I just spoke with Kimberly at Pacificare and she told me I have to do my follow up care with a different surgeon. If you have Pacificare and are scheduled to have surgery, HOW do you want to proceed? Meg Alexander from Channel 4 is ready to do a story on this. I told her that I'd be a reference for Dr. Floyd and that he is a very good surgeon. Her slant on the story will be how Pacificare is basically denying people a medically necessary and life saving surgery. Do you want to proceed with the media? Or do you want to wait. All other state insurances have a permanent exclusion for weight loss surgery, and Pacificare will not be offered after December 31st.

Leslie, From what I understand from talking to Kenny (this was prior to my surgery) Dr. Floyd will be a provider for Community Care HMO, for those of us that are Post-Op our follow up care should be covered. Dennis

good to know. . very good to know!

is it just Dr. Floyd pacificare is not covering or justnot covering in general?

I am a member of pacificare with Dr. Floyd, and am still scheduled for surgery on 11/12/04, thanks to all the hard work Kenny has done this last week. I didnt realize that after 12/31/04 pacificare will no longer be covering bariatric surgery. I know when i signed up for pacificare I had my choice between PPO or HMO, so I called pacificare and they mentioned an exclusion for bariatric surgery with PPO, with HMO it must be medically necessary. Made my decision easier. I cant see them excluding bariatric surgery when it is medically necessary. bunch of bs.

I am a Pacificare member and they are leaving the state of OKl is what I understand. I have to switch to Community Care in Jan also. I was on the waiting list for Dr. and they are not going to do the surgery anymore at Mercy Hospital. I understand the state insurance companies are putting it in as exclusion. So I'm back to where I started. NOt sure how I'm going to get this surgery done as of now. I don't understand how this is possible if it is medically necessary. I feel that someone should be bringing this to attention of the media. Maybe something can be done as a result. I'm hoping that something will change to make this surgery possible for those of us that need it. JUDY