Back to trying to get my surgery

Ruby3901
on 7/19/09 7:32 am - OH
Hello Everyone,
I have been having quite the problems with getting my surgery. I was working for a company who had BCBS insurance out of IL. I went through just about every test imaginable and also went through a "physicians diet program" to meet the insurance company's requirements. Of course after all of that they would only approve a RNY and I will never agree to that surgery.

While fighting and appealing the insurance company I lost my job. I was out of work for three months and now have a new job and with it comes a new insurance company. I have "Aultcare Insurance" now. They are out of Canton, Ohio. Does anyone out there know if they will pay for the surgery?

My other fear is that I will need to do all the testing again. Does anyone know how long the test results remain usable?

My family does not want me to go to Mexico and of course my doctor in Akron Ohio does not take self pay.

I'm trying to fight the good fight but don't know what I will do if this insurance company doesn't cover my surgery.

If anyone has any suggestions or can give me some advise it would be greatly appreciated.

Thank You
Robin W.
on 7/20/09 11:18 pm - Franklin, OH
You should call your new insurance and ask what they cover and what types of WLS not every policy covers every WLS. Also I have never heard of any doc not taking self pay.  Every hospital and doc in Cin and Dayton take self pay and have a discount for it also.
Good Luck,
Robin

4'10" - 47 I'm short but not petite and I will weigh more than a 5th grader
Start weight 220 
"Be who you are and say what you feel because those who mind don't matter and those who matter don't mind"  Dr. Seuss

Cicerogirl, The PhD
Version

on 7/21/09 2:32 am - OH
As Robin said, you will need to check directly with your insurance company... different companies can have different policies even though they use the same insurance company... to see if they cover ANY weight loss surgery and, if so, which ones they cover.  (Many currently will cover only RNY.)

Lora

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

Ruby3901
on 7/22/09 9:43 am - OH
I was in the middle of appealing to BCBS when I lost my job and medical benefits. Now I have a new insurance company and I checked with them as did my doctors office we both were told the same thing "my benefits do not include ANY weight loss surgery's." I'm currently trying to comer up with plan C since A & B both got shot down. I had a spinal cord injury about four years ago and have foot drop and back issues. I also have high blood pressure, sleep apnea, and migraines. Its hard to be wanting the surgery so bad and physically needing it and realize I'm at the mercy of a bank now. Thanks to everyone for their input I will be doing some more checking around.
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