Discouraging

(deactivated member)
on 7/21/11 5:23 pm, edited 7/21/11 5:33 pm
DS on 02/01/12
My husband may be losing his job and, consequently, losing our insurance. Great. I'm terrified that, whenever he does get another job, their insurance won't cover bariatric surgery. Then, I recently made the decision to switch surgeons from Barker to Stewart, and contacted Dr. Stewart's office on Monday about making the switch. Their response was that Dr. Stewart would have to approve me as a patient (since I am coming from another surgeon) and that they would get back to me. Well, it's now Friday. I called the office a second time this week and was told that he still hasn't made the decision. I can't help but feel that, even if my husband doesn't lose his job (and God forbid he does), that it doesn't matter anyway because I won't have a flippin' surgeon. I totally get that he (Dr. Stewart) is a busy man and all, but being left hanging in the air without a definite decision tends to make one very anxious, to say the least.

Needless to say, I feel like giving up. I know that I can't, but I honest to God feel like it. Seems like every time I take a step forward with getting DS'd, I get knocked two (and sometimes three) steps backward. It's discouraging and depressing to know that, the one time I try to do something for myself, crap like this happens to prevent me from having a healthier life. This was my fear from the beginning - and now it looks like it's actually coming true.

I feel like praying and cursing all at the same time! Stupid insurance company and their 6 months of supervised diet garb. Gah! Sorry for being a Debbie Downer, but I just needed to vent and I figured that you all (or at least some of you) would understand.
StephOinAZ
on 7/21/11 6:22 pm

Erika I'm so sorry :(  I completely know how you feel!  This entire process has been the most testing experience of my life.  I have been fighting tooth and nail for this DS for almost a year now!  First with the back and forth with my insurance company, the denials, the appeals, the crying, the yelling at my surgeon's office-- then my husband and I decided to call it quits and get a divorce.  I'm on HIS insurance, and it's HIS insurance that is paying for this, so I panicked.  Thankfully my soon to be ex and I are still friends and he cares deeply about my well being, so he agreed to not file the papers until after my surgery.  So once they FINALLY approved me after having to self pay my band removal, but I had to get updated Dr's visits, referral letters, psych reviews, the works!!  Then when I get all that done they schedule me super far out!  After all that work and I was still going to have to wait until almost the end of the year!  So I switched surgeons and then had to start the process all over again.  I had to deal with incompetent office staff, the insurance company AGAIN, and more waiting and waiting to get phone calls that seemed like they never would come.  Now I'm less than 2 weeks from my surgery (YAY!) and I am STILL having curve balls thrown at me!  I busted my ass to save up the amount of money the hospital said I'd have to pay for my self pay and insurance, got that all saved up and then a few days later I find out that's JUST the hospital's fees, not my surgeon's fees.  So then I had to come up with MORE money, somehow managed to get that just scraping by, and then this morning after FINALLY figuring out how to pay for it all, I got a call saying that I was going to have to pay ANOTHER $1,000 to my insurance!!!  Needless to say I was absolutely RAGING today.  Thankfully God smiled down on me and directed me to the help I needed, so my stress levels have come down a little.  But come on...what next?!?!?  It gets to the point where you just have to sit back and say "bring it on!" and face it head on.

 Sorry- guess I had some of my own venting to do and decided to do it on your thread ;)

 THE POINT IS-- you aren't alone, most of us totally understand the stresses you're going through.  The DS will be worth it, don't give up!  Keep fighting for it and in a year you'll look back and be glad you did :)  I truly hope that everything works out for you!!  ((Hugs))  Keep us posted!

airbender
on 7/21/11 7:23 pm
economy is tough, but you do have other options.  first this is life, and it will not be the last road block in your life.  I had to switch surgeons so many times (as no one would take me as I was so high risk)  I had to fly for surgery.  I had a HMO, I had to appeal to have out of network benefits.  if dr Stewart doesn't want you as a patient find a surgeon who will take you.  if your husband loses his job, you find a job and get insurance coverage that way.  life is always filled with road blocks, DS is not main stream, this will teach you to be an advocate for yourself, you can't give up this early in the game, life is not easy, sometimes it stinks.  this is your health, it is worth fighting for, and doing what you have to do to get and keep insurance coverage, and like I said dr Stewart is not the only surgeon, call others, even if they are further, start doing that now, don't put all your eggs in one basket.  wishing you well for your future surgery....
(deactivated member)
on 7/21/11 10:45 pm - Beverly, NJ

I wish I had some type of help or suggestion for you.  

Hang in there though.  It's all worth it in the end.  Use this to make you stronger and more determined to be a healthier you!  

 

*hugs*

larra
on 7/22/11 12:10 am - bay area, CA
Don't give up! You may be closer to success than you think. Keep on calling Dr. Stewart's office, call every day, and in the nicest, most polite way make it known to them that you may be losing your insurance and need an answer ASAP. Be a squeaky wheel, but a likeable squeaky wheel.
     It is unfortunate that it takes so much effort to get the insurance coverage you (or your employer, or at any rate someone) is paying for, but you are far from alone, and even many people who want the much more common RNY often get initial denial, have to jump through ridiculous hoops, etc. for medically necessary care that their policies clearly cover. If you persist, you will succeed.

Larra
scoob
on 7/22/11 12:32 am - Somerset, KY
Do NOT give up. Took me 2 years but here I am! I think in MY case it all worked out for the better. I switched surgeons too and had to jump through all the many hoops but it has been soooo worth it so far. I almost gave up a time or two but the good people here and a few IRL  WLS friends helped me keep my eye on the prize. Just keep keepin on girl! HUGS


Ruby

 

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Kayla B.
on 7/22/11 12:39 am - Austin, TX
I really hope your husband does not lose his job, for reasons beyond just insurance.

If it makes you feel better, I know a couple of people that have switched surgeons to Dr. Stewart, no problem.  I don't think there will be an issue there, but I suppose it will depend on whatever relationship Dr. Stewart has with Dr. Barker.
5'9.5" | HW: 368 | SW: 353 | CW: 155 +/- 5 lbs | Angel to kkanne
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a_new_mii
on 7/22/11 1:40 am - AZ
 Erika,
Please don't give Up!!  It absolutely will be worth it when you're on the other side!  I have been fighting insurance companies and uncooperative Dr.s since 1993!!! Finally this past April was the beginning of my new life!  I ended up having to self pay (a passing gift from my Daddy), but here I am 3 1/2 months out and feeling better than ever.  
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ThisIsMyUserName
on 7/22/11 6:39 am
Is COBRA an option?


http://www.dol.gov/ebsa/faqs/faq_compliance_cobra.html
 As far as I can tell it has to be the same or similar coverage as what the employee had while employed. So essentially, it most likely the same coverage as what the person had while working, the only difference is they pay like 7x more for it. You could maybe pay for COBRA by hook or by croo****il you get your surgery??? In that case thats all the more reason to keep plugging away at the pre op req's and not get frustrated and stop getting things done. That way you wouldn't have to keep paying for COBRA as long.  You have no idea how completely I understand what you are going through....The stress and uncertainty can literally make you feel ill...BUT I would take this time to be as persistant as possible, I would also try and figure out more about what my COBRA options would be if it comes to that...which it's entirely possible that  it WON'T!!! Keep you chin up!!! You'll get there...
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