Feeling discouraged

kjm92002
on 9/4/10 1:40 am - gastonia, NC
I recently had to change my insurance from a medicare supplemental insurace (Humana PFFS to Humana PPO)so now instead of paying 20% of the surgery i now have to pay over 30%, because Dr V is now out of network and the hospital (presbyterian) is also out of network, I'm putting this info out because I don't know what to do now, because financially I may not be able to have the surgery. So far I have put so much time energy and Money into all the pre opt classes and appointments, and now it seems as if i have hit a brick wall. If anyone can advise me on what to do if they have been in this type of situation, maybe advice on another type of insurance I could get to cover the gaps that medicare and humana doesn't cover or a place that makes loans for bariatric surgeries or any type of advice or sugestions, it would be greatly appreciated.
Barbara C.
on 9/4/10 12:53 pm - Raleigh, NC

I'm so sorry to hear of your struggles. I would suggest that you consider posting/crossposting this to the Main, RNY and Insurance forums to see if there are others that have had a similar situation and might be able to offer some constructive advice. 

Wishing you all the best,

Barbara
ObesityHelp Coach and Support Group Leader
http://www.obesityhelp.com/group/bcumbo_group/
High-264, Current-148, Goal-145

kjm92002
on 9/9/10 3:57 am - gastonia, NC
Thank you for responding with that info, i sure will repost, and next time i post hopefully it will be better news, thanks so much....
(deactivated member)
on 9/8/10 11:47 am - Yorktown, VA
Have you checked to see if other WLS surgeons are in network?  You can often just transfer your records and pick up right where you left off (or close) with a new surgeon.
kjm92002
on 9/9/10 3:54 am - gastonia, NC
Thanks for your reply, you know I was so devastated when I got that info, that i did'nt think about going that route, thank you so much for reminding me that there are other options,.... greatly appreciated
daisymom
on 9/11/10 12:51 am - Belmont, NC
Hello from your neighbor in Kings Mountain!  :-)
I traveled to Dr. Sudan in Durham. See if he's in your network. You'll like him. I started out first seeing Dr. Voellinger, but later I switched to Dr. Sudan.
Hope everything works out for ya!
Cheryl
kjm92002
on 9/11/10 7:04 am - gastonia, NC
ok thanks i will look into that, did you have to change from dr V, because of insurance issues too?
daisymom
on 9/11/10 9:31 pm - Belmont, NC
I didn't change because of insurance issues. I changed because Dr. Voellinger wanted to put a band over my gastric bypass, and I didn't want that. See, I had revision surgery. Dr. Sudan converted my proximal RNY to a distal RNY.
What kind of surgery are you planning on having done?
Cheryl
kjm92002
on 9/12/10 4:25 am - gastonia, NC
I was having the RNY but after reading a lot more on the topic a DS sounds more effiecient, I guess first before trying to change which surgery to have, i should first find an in-network surgeon, keep you posted
daisymom
on 9/12/10 9:34 am - Belmont, NC
Definitely keep us posted. While you're finding a surgeon in your network, you can also research your WLS options. If I was able to do it over again, I would have the DS in a heartbeat! Research, research, research!!!!!
Good luck to ya and keep me posted on your progress!
Cheryl
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