Unreal Insurance Issue That Could Ruin Everything..Very, very long
Yesterday I found out I have lost 40 pounds since my consult. Yeah!!
A couple hours later I opened my mail to find a notice from my state health insurance provider that they are discontinuing my coverage effective 8/7/07! What???? That's a week away 
. Why are they doing this? Because my disability income is too high. Yup, get that. I'm trying to figure out how to pay for healthy food and protein shakes, let along the clothes I will need when i get below the smaller sizes I have, and they think I have too mu*****ome. Grrrrrr...... So here's the best part. Massachusetts passed a law that effective 7/1/07 everyone in the State is REQUIRED to have health insurance, UNDER PENALTY OF THE LAW!! So the State Health Insurance plan is telling me I now have to go to the new state promoted providers who are required to sign us "uninsurables" up for insurance. This means I will now pay a premium and deductibles that I didn't have, and have ten-fold payment on many of my prescriptions. I will have to get a new PCP, of which I have only one choice in my area, and I will have to wait several months for my initial appointment. Then I will have to switch to another hospital for my WLS, and begin the process all over again to meet that programs requirements. I will also go without insurance from 8/7 until 9/1.
Thank goodness I am stubborn and computer literate. 
I figured out how to stay on the state insurance, but on another level. The catch is I have to find a job ASAP and work at least 50hrs/month. This is not what anyone on my support team wants me to do. The plan was to wait until a few months AFTER surgery to begin to consider the return to work issue. Now I have no choice, and I have to find something where they won't mind that I need time off in about a month. And to top it off, I am going to be playing a race with the state because in order not to lose my current coverage, I had to appeal the decision, and I have until the appeal hearing (which will be when???) to have a job in hand.
Okay, let's make this even more nerve-wracking. Guess who is waiting for insurance approval for WLS??? You got it!! When I called my surgeon's office today to alert them, they said they just need a signature to send in the request. THEY HAVEN'T SENT IT IN YET!!! I am scheduled for surgery on 9/11.
My head is spinning. No one in my life gets this. My therapist is even overwhelmed and angry by it. I have a ton of issues surfacing from the change losing weight is bringing up for me. I already had job issues and I won't go into that. I can't think of how to numb since food isn't an option. I just want to stare at the tv or dive into books and isolate myself. But I needed to write to you guys.
Sorry this is so long. If you're still reading, thank you so much.
-Julie
A couple hours later I opened my mail to find a notice from my state health insurance provider that they are discontinuing my coverage effective 8/7/07! What???? That's a week away . Why are they doing this? Because my disability income is too high. Yup, get that. I'm trying to figure out how to pay for healthy food and protein shakes, let along the clothes I will need when i get below the smaller sizes I have, and they think I have too mu*****ome. Grrrrrr...... So here's the best part. Massachusetts passed a law that effective 7/1/07 everyone in the State is REQUIRED to have health insurance, UNDER PENALTY OF THE LAW!! So the State Health Insurance plan is telling me I now have to go to the new state promoted providers who are required to sign us "uninsurables" up for insurance. This means I will now pay a premium and deductibles that I didn't have, and have ten-fold payment on many of my prescriptions. I will have to get a new PCP, of which I have only one choice in my area, and I will have to wait several months for my initial appointment. Then I will have to switch to another hospital for my WLS, and begin the process all over again to meet that programs requirements. I will also go without insurance from 8/7 until 9/1.
Thank goodness I am stubborn and computer literate. I figured out how to stay on the state insurance, but on another level. The catch is I have to find a job ASAP and work at least 50hrs/month. This is not what anyone on my support team wants me to do. The plan was to wait until a few months AFTER surgery to begin to consider the return to work issue. Now I have no choice, and I have to find something where they won't mind that I need time off in about a month. And to top it off, I am going to be playing a race with the state because in order not to lose my current coverage, I had to appeal the decision, and I have until the appeal hearing (which will be when???) to have a job in hand.
Okay, let's make this even more nerve-wracking. Guess who is waiting for insurance approval for WLS??? You got it!! When I called my surgeon's office today to alert them, they said they just need a signature to send in the request. THEY HAVEN'T SENT IT IN YET!!! I am scheduled for surgery on 9/11.
My head is spinning. No one in my life gets this. My therapist is even overwhelmed and angry by it. I have a ton of issues surfacing from the change losing weight is bringing up for me. I already had job issues and I won't go into that. I can't think of how to numb since food isn't an option. I just want to stare at the tv or dive into books and isolate myself. But I needed to write to you guys.
Sorry this is so long. If you're still reading, thank you so much.
-Julie
Oh my gosh, what a nightmare! I don't know how you keep track of all that, it was making my head spin.
Come back and vent all you want - during all of my insurance issues this place was my lifeline. It was just hard to go through, so I know how you feel. Wish I could help in some way,but I hope being here to listen helps 
Love ya hon
Pam
Love ya hon
Pam I'm glad it's not just my head that's spinning. I admit I had to keep really good notes as I figured it all out and then got confirmation on the phone. The problem now is that all my brain cells are full and I have no more available until I do a format 
.
To keep myself from too much negative thinking, I am trying to convince myself that if surgery becomes not an option, I can continue to lose weight like I have been, especially if I keep on this board for support and inspiration. Even if I won't have the same tool, I am making the life changes all the same. I just can't find support like this anywhere else. People who understand that diets don't work. Did I just say that? Oy......
-J
.
To keep myself from too much negative thinking, I am trying to convince myself that if surgery becomes not an option, I can continue to lose weight like I have been, especially if I keep on this board for support and inspiration. Even if I won't have the same tool, I am making the life changes all the same. I just can't find support like this anywhere else. People who understand that diets don't work. Did I just say that? Oy......
-J
Congrats on the weight loss! 
I'm confused about your insurance situation. Are you on SSDI (federal Social Security Disability)? If so, are you on Medicare? With Medicare, this shouldn't even be an issue. If you're on state disabiltiy and use MassHealth, I'm sorry I'm not familiar enough with their system to offer anything helpful.
Your current insurer is required to give you a certificate of portability, which means if you do have to switch to a new insurance plan, there shouldn't be any kind of waiting period to cover pre-existing conditions.
I know what you mean about premiums, etc. Even with my Medicare HMO, I still pay $148 a month in premiums, and when I kept getting cellulitis last year, those big bags of vancomycin and itty bitty bags of whatever it was they gave me ate through my prescription drug benefit in a couple of months. Last year, I paid $3700 out of pocket for drugs and didn't hit the catastrophic level for free drugs until 12/30/06. Of course, when the new year rolls around, you start all over again. Thank heavens I have had a relatively good year in terms of not needing expensive prescription drugs. My SSDI is too high to qualify for any kind of premium assistance or extra help with prescription drugs.
If you feel comfortable, email me privately and give me more details. There must be something to do, and how dare they yank your coverage with barely any notice?! 
Kix
I'm confused about your insurance situation. Are you on SSDI (federal Social Security Disability)? If so, are you on Medicare? With Medicare, this shouldn't even be an issue. If you're on state disabiltiy and use MassHealth, I'm sorry I'm not familiar enough with their system to offer anything helpful.
Your current insurer is required to give you a certificate of portability, which means if you do have to switch to a new insurance plan, there shouldn't be any kind of waiting period to cover pre-existing conditions.
I know what you mean about premiums, etc. Even with my Medicare HMO, I still pay $148 a month in premiums, and when I kept getting cellulitis last year, those big bags of vancomycin and itty bitty bags of whatever it was they gave me ate through my prescription drug benefit in a couple of months. Last year, I paid $3700 out of pocket for drugs and didn't hit the catastrophic level for free drugs until 12/30/06. Of course, when the new year rolls around, you start all over again. Thank heavens I have had a relatively good year in terms of not needing expensive prescription drugs. My SSDI is too high to qualify for any kind of premium assistance or extra help with prescription drugs.
If you feel comfortable, email me privately and give me more details. There must be something to do, and how dare they yank your coverage with barely any notice?!
Kix 
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