Insurance changes for 2005!

nursekuba
on 10/7/04 7:49 am - Phoenix, AZ
Hi, everyone. I'm trying to get surgery done and I'm unfortunately just starting on this and need to meet with the surgeon and send paperwork in for insurance approval, etc. I have United Healthcare. I should have worked on this before, but I hadn't seriously decided to have the surgery. Well, United covers bariatric surgery, but there's insurance plan changes for 2005 and I don't know if my new plan will cover it. It'll still be United, but it's changing. It's October now but I'm beginning to feel like 2005 is coming way too quickly. I called the number for info on the new plan, and they can't tell me if I get all this stuff done this fall and (hopefully) get it approved, if that approval will continue over to next year. They don't even know if they'll still cover bariatric surgery next year. I'm freaking out. I'm doing my best to get everything done quickly, but I can't get an appt with the surgeon until Nov 8. They have some openings the week before, but I'm going to be out of town on vacation. Should I stay in town the previous week and make my vacation the next week? I have an appt with the dietitian and a pulmonologist week after next. I need to hear back from the psychologist to make an appt with her. I'm just so scared that my window of opportunity to get surgery will be gone if I have to wait til next year!
czangel
on 10/7/04 1:24 pm - Greenfield, WI
Katherine, I'm facing a similar issue with Humana. The plan is to drop bariatric surgery as a covered benefit because (1) so few use it, and (2) most everyone who has had surgery, per the County, has had multiple complications so causing it to cost more than originally plan. (I personally think that's a lot of hooey, so they don't cover it). However, our premiums are supposed to double, not sure about deductibles and co-pays. If I can get my couple of snags worked out (2nd psych eval, and B-12 up), then hopefully can have the surgery around the end of the year, at least that's MY plan!
Marsha S.
on 10/14/04 1:59 am - Sheboygan, WI
Hi Katherine, I have a similar situation with my insurance. I do not know at this point if coverage will be dropped, but I plan on having the surgery before the first of the year. I am a bit ahead of you. I have finished all my tests and my paperwork has been submitted to insurance. So....I'm in the waiting game. If I were you, and you are VERY serious about having this surgery, I would put everything else on hold (if possible****il I have done everything I can to jump through the hoops. If you can change your vacation to a week later, I would. If you can move any appointments up, I would. Make sure you talk to your surgeon to make sure he is even AVAILABLE to fit you in before the first of the year. Also, if you are in the hospital when 2005 comes, will they cover those days of hospitalization if it is related to a dropped coverage. They are always trying to get out of one thing or another if they can. Good Luck to you!!! Marsha
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