One More Blow

Well after a good tip I followed up on some VA approval for my surgery.  I am running a business and a family.  Things are ok but we would be considered middle income.  Well the VA considers us wealthy.  If a family of 4 pulls in more than 37,500 combined household income they do not qualify for benefits according to the screener I spoke with.  I have more than 37500 in bills, mortgage, debts.  Whats left pays my taxes and deductibles on insurance and if we are lucky we have 500 to blow on vacation a year.   Just one more no in a long lists of no. 

Sorry to hear that Dave. Wish I had words of encouragement, but I can't even imagine going through what you have. Best of luck, Troy

My insurance company has informed me , literally, that even if I was on my death bed, they would not pay for surgery under any criteria.  I had an approval under appeal.  Turns out that the approval itself was a mistake and the appeal never should have been alowed.  The VA says I make too much money.  Does not matter how long I want to extend my life a 40,000 loan to cover all plus cover any complications which could run into 100,000's if something went wrong would all be out of pocket, I still have to be able to pay for it which under my salary which is all commission there is absolutely no way to do that or forcast it.   The Ins. company would not cover any complications as I am informed as it is all related to an excluded procedure.   I am stuck, there is little hope and I am relying on the OCI to force the Ins. co to abide by their approval even though it was a screw up.

It is probably the mostf frustrating part of the whole process, except the pysch evaluation if you get one that wants to milk you for counseling sessions.

But it only takes a supportive prefferred physicain and one yes to get it going.

If youare not paying on your own, find out your insurance requirements anf then abide by them, even if it means making some phone calls to get some clarityon what you have to do and in what time frame.  If you are paying on your own, its a debt against extending your life.

It onlyt takes one yes but it is a 6 to 12 month process most of the time.

Sorry I couldn't be more cheery.  But hangin there.  Many of us have been where you are abd are pulling for your success. 

I live in Southwest Texas along the Northeastern border with Mexico.If my insurance had not come through my PCP had already begun a search of Mexican Hospitals. He made contact with several who would do Gastric/ Bands for less than 10,000. Just an option.

Have you sought an attorney's help?  There are attorneys that advertise on this site, that specialize in this type of matter. In addition you might want to check with the labor department of your state, and find out about rehabilitation help.    There is a woman in texas (who frequents the chat room) who is getting a RNY through the FL rehabilitation office.  Her insurance doesn't pay for WLS, and her weight is a "disability" which prevents her from moving further in her career.   She works full time, yet can't afford to pay for surgery on her own. Also someone mentioned out of country surgeries...there are several experienced surgeons outside the US....I'm only familiar with DS surgeons....of which there are 3 that have many DS patients that frequent the DS forum. Good luck to you. Scott

Thank you all for the help and monitoring of my battle.  I will not under any cir****tances go outside the US.  That may seem like I don't want it bad enough, call as you want but it's not happening.  At this point I will continue to look for different avenues and continue getting on my eliptical.  If the good Lord wants me to get this surgery at some point he will show me a way and until then I have personal struggles to battle, children to raise and a family to provide for.    I am expecting a call from my company in the morning as they left a message but I do not expect good new.  It is not out of my hands but I don't think now is my time.  Maybe one day.   Good luck to all of you perhaps I join you again someday.