Recent Posts
Topic: Using pictures as proof of weight
So I submitted my paperwork to Aetna and they requested two years of weight history....2009 and 2010. The ONE doctors appointment I had in 2009 which was an ER visit they didn't record my weight. I have no earthly idea of what to do now. Could I use a picture with the date stamp on the picture as proof of weight?
Topic: meeting high deductible
Hello all. I have a question about how to meet my high deductible. As I mentioned in an earlier post, I have a policy through BCBS of nc, and my deductible is 10k. They will not pay for ANY services until i meet this extreme amount, and I haven't done any of my pre-op tests yet. My question is this: how can I meet my deductible if they won't pay for anything? I mean, do I show my insurance card when i get each test done even though I know that they're not going to cover it, and let bcbs bill me, or will i still be required to pay upfront? Any insight will be appreciated.
Topic: Getting approved on Medicaid in NJ with Bipolar/Addiction Issues
Hi, I'm brand new to this forum and am not sure if this is the right place to make this post, so bear with me :) Quick intro: I'm 32 years old, 5'7" and am 360 pounds, give or take. I have health issues including severe sleep apnea, I've fractured both ankles, high blood pressure, asthma & a fatty liver. I also have mobility & skin infection problems from loose skin, mostly undocumented though. I am on Medicaid insurance - Americhoice/United Healthcare HMO - and live in New Jersey. I've struggled with my weight my whole life and should have no issue with documenting that - I've had many a doctor's visit, sleep study and hospital stay. Point of this post: I found a doctor who takes my insurance and have a meeting with him next month. A couple of things that I could see being an obstacle, are the fact that I'm bipolar with a long string of hospitalizations behind me (none in 3 or 4 years, though - I'm fairly stable at this point) and that I'm a recovering addict. The addiction only covered a spanse of 4 or 5 years, but things got bad - for instance, one of the fractured ankles happened when I was intoxicated, and I've been in detox, etc. I am over 18 months sober, and that is documented, as well. How likely is it that these things could get in the way of this going through? A friend suggested that I downplay, or even lie, about the bipolar and the addiction, but I wouldn't want that to come back to haunt me later. Your thoughts?
-CW
-CW
Topic: RE: Self Pay
I was self pay and here in Charleston, SC the Medical University wanted almost 28k stating that was inclusive but it didn't include the pre-approval appointments which would have run around 500.00. I couldn't afford to have it there so I went to overseas to India. With airfare, procedure, visa and 4 nights in a really nice hotel my cost was a little under 13k almost two years ago (surgery was on 4/1/09). I made arrangements with my Internist to do follow-up care. His only question was where I was going overseas and when I told him India he said fine. I asked if he would have said yes if I told him I was going to Mexico and he said he wouldn't have done my follow-up care if that was the case.
My experience in India was really good. My Internist was completely blown away by how extensive their pre-op testing was (said it was better than MUSC would have done). While the hospital wasn't as 'pretty' as the ones here, it was spotless and the nursing care was almost too helpful. The plane ride home was a little tough but not horrible. All in all, I'm really glad I choose this option. I haven't had any complications and I'm 3lbs from being half my size (302lbs at time of surgery). I had my surgery at Wochart Hospital in Mumbai but I think they were bought out by the Apollo chain sometime last year.
My experience in India was really good. My Internist was completely blown away by how extensive their pre-op testing was (said it was better than MUSC would have done). While the hospital wasn't as 'pretty' as the ones here, it was spotless and the nursing care was almost too helpful. The plane ride home was a little tough but not horrible. All in all, I'm really glad I choose this option. I haven't had any complications and I'm 3lbs from being half my size (302lbs at time of surgery). I had my surgery at Wochart Hospital in Mumbai but I think they were bought out by the Apollo chain sometime last year.
Topic: RE: OUT OF POCKET COST WITH AETNA
Open yourself to possibility and possibility will present itself.
It depends on your plan. I have Aetna and my out of pocket will be $5000. I hope to God yours will be less.
Open yourself to possibility and possibility will present itself.
Topic: RE: BCBS??? I'm confused Please Help
I have Mountain State BCBS (West Virginia) I did my six month pre-op dieting with weigh****chers, but I had to go to my primary care dr once a month to be weighed and have him sign the form. Hope this helps. It is worth the effort to get approved, no matter how many hoops they put in front of you. My surgery was covered at 80% and most of my labs and pre-op testing were completely covered because I had met my deductible.
Topic: PLASTIC SUGGESTIONS
Hello erveryone need help i was denied by commonwealth care bmc for my panni removal they keep saying its medically necessary has anyone been denied and appealed and won i need help writing letter even if they helped pay for it.. please any suggestions
thank you in advance
catherine
thank you in advance
catherine
Topic: RE: Tricare Prime North question
oh and 1 more thing each tri care region is ran different so your tricare maybe ran different then tricare north. I know it sucks but i wish you the best of luck.
Topic: RE: Tricare Prime North question
Well my BMI is 62 and i am 5'3 and i weighed at the time of my first appointment with the surgeon 350. If you have no comorbities you have to be 200% over your ideal body weight which i do meet. I have since talked to others that have tri care prime north and they have had no issues so i can help for the best :) thanks for your response. I have my second appointment with the surgeon tomorrow. I have done the checklist that my surgeon has provided and tomorrow we should be scheduling my surgery date. Good luck with your denial :)
Jess
Topic: Supervised Diet Question
I'm a 5'9", 33 year old mother of 2 living in Sunny San Diego
Starting Weight: 273 Surgery Weight: 235 Goal Weight: 140 Surgery Date: 08/08/11
I'm going to be submitting for approval to BCBS of Illinois in the next 2 weeks.I'm wondering if your medically-supervised diet was 3 visits (each a month apart) or 3 months total? I'm worried because even though I will have done 3 visits, one month apart, I will have submitted to insurance after only 2 months (i.e. I went for my first visit on January 6th, the second visit on February 11th and the third visit will be on March 10th - but January to March is only 2 months).
Do you think I have a shot of getting approved? I'm worried because BCBS of IL will be changing their requirements from a 3 month diet to a 6 months diet on March 15, 2011 - and I will be submitting to insurance on March 10th (talk about cutting it close!!!)
Do you think I have a shot of getting approved? I'm worried because BCBS of IL will be changing their requirements from a 3 month diet to a 6 months diet on March 15, 2011 - and I will be submitting to insurance on March 10th (talk about cutting it close!!!)
I'm a 5'9", 33 year old mother of 2 living in Sunny San Diego
Starting Weight: 273 Surgery Weight: 235 Goal Weight: 140 Surgery Date: 08/08/11
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My insurance will not pay for my excess skin that hang down to my knees
Hockeymom87 · 0 replies · 605 views
Hockeymom87 · 0 replies · 605 views
