Kari J.
One Step Closer
Sep 23, 2008
Then yesterday I received an email from someone within HR at Iowa Health Des Moines telling me she had received my email (I hadn't even sent it to her so I guess I must have sent it to someone correct!). She also told me she would be looking into it and getting back to me.
Just a little bit ago I got an email to call the gal in HR so I of course immediately went to an empty patient room here at work for some privacy and called her. She said she was really glad she had received my email and felt it was very professional and to the point with great information. She let me know that she was working in conjunction with the CEO of Iowa Health Des Moines, the Chief physician at my hospital, and the head of my Bariatric Clinic to get me approved. They are going to push to implement the 6 month diet starting immediately for me so I can get approval and have my surgery before the end of the year. I should get word on whether it goes through by the middle of next week.
I am so excited that I finally had one positive thing happen in relation to my insurance. It has been such a frustration and so this one positive is really uplifting for me. The gal in HR was so incredibly wonderful and so compassionate and you could tell she really did understand my situation and really truly wanted to help me.
This has been great and I feel like this week is going to be fabulous now that I got this great news!
More soon!
Bringing it all up to date
Sep 15, 2008
Plenty has happened since my last post so I thought I would make another post to update everyone.
First, I was denied on my appeal. I knew it was going to be a denial, so this was no big deal. However, I think I must have still had some glimmer of hope that the insurance company was going to be sympathetic so when I got the actual letter in the mail it was a really big downer for me. But I knew it was coming and I knew I had to look forward to finishing my 6 month diet to attempt another appeal. Every month when I go in to see my PCP we discuss how ridiculous it is that this is a requirement. She's stopped charging me for the visits (she's amazing seriously). Paying copays every single month adds up so I thought it was just fabulous.
I was trying to stay focused and positive but I had a big letdown this past week. As I wrote before the reviewers at my insurance company told me to exhaust my appeals in an attempt to get my company (the insurance just manages it, my company has overall say over what they will cover if it gets appealed) to approve me this fall after completing the 6 month supervised diet. The reviewer seemed confident I could get it approved because they are changing the requirements from a 12 month to a 6 month supervised diet starting January 1, 2009. Well I finish the diet next month so I've been gathering information in preparation so I could send everything in immediately after my appointment. I called my Bariatric clinic to get some paperwork and that's when I got the giant letdown. I explained to the financial counselor what I was needing the paperwork for and she informed me of two things. One, my company hasn't put definite approval on changing to the 6 month supervised diet like they told me. And two, if I exhaust my appeals and they still deny me I CANNOT resubmit after the first of the year. WHAT!?!? Yes, indeed, if they deny me I'm DONE. I specifically asked this of the insurance reviewer and she told me no, I could resubmit if I'm denied and told me to go ahead and exhaust all my appeals. I told this to the financial counselor and she said of course, an insurance company is not going to tell you that you can't legally resubmit when they are trying everything they can to not approve me in the first place. I was FURIOUS. Not at my clinic but at my insurance company who had once again thrown a monkey wrench in my quest to become healthy. I'm getting enraged all over again just typing this up!!!!!
So anyway, I decided to take action. I wrote out a detailed letter explaining how our company (that would be Iowa Health Systems for all you interested parties) is waving the fact that they cover Weight-Loss surgery in front of our faces by sending out system-wide emails saying how they cover this and then placing every roadblock they can in the way so they don't actually have to cover it. So I pulled together my statistics and personal story and wrote this letter. I then emailed this letter to the top. I would have sent it to Human Resources but I sent them something at the same time I did my appeal and got NO response. So the CEOs of Iowa Health Systems, Iowa Health Des Moines, and Methodist Hospital got my emailed letter. I thought for sure I would get at least ONE response--even if it was that they really couldn't do anything to change it. But I have gotten NOTHING. I'm beginning to think with my current insurance I will never be able to get this surgery.
So now I am considering a job change to an employer who doesn't block access to needed healthcare. I like where I work and I absolutely love the people I work with, but I have come to the point where I need to put my health above these things. I will have to find the perfect job to leave so right now I am continuing to fight to have my surgery but I am also keeping my options open and exploring new employers.
The saga continues.....
My First Blog
Aug 06, 2008
Here they are:
Riding and showing my horses because I feel guilty getting on them because of my weight.
* I could only take so much of my horse trainer telling me that I need to lose weight and having conversations with other trainers about how much more “drag” my weight puts on the cart—and not understanding why he can’t understand that what he’s saying is so painfully obvious to me every day and his reminders only make it worse for me.
*Going to horse shows and watching everyone else do what I want to be doing—and wanting to be there so badly but each time leaving more depressed with the reality of what my weight is doing to me.
Each time I get on an airplane wondering if this will be the time I have to face the complete embarrassment of asking for a seatbelt extension.
*And when I somehow manage to “suck it in” enough and get the standard belt on I am uncomfortable for the entire flight. And it’s not just because of the belt—it makes me sit in a position that hurts my hips so badly I often have excruciating pain that makes it hurt to even walk.
Knowing people treat me differently as a result of my weight—even when they don’t mean to do it.
At family functions with my extended family looking around and realizing I’m the fattest person in the room—and wondering if everyone else is noticing the same thing.
Wishing I could walk up a flight up stairs or a hill or even just a flat surface sometimes and not become short of breath.
Knowing that if I have babies and am in a situation where I need an emergency delivery that my current weight could make it so difficult to get to the baby quickly that he or she could have permanent damage or even die.
Knowing that I don’t love myself and if I can’t love me then I can’t allow someone else to love me.
Wanting to be comfortable enough with my body that I can go the pool on hot days and cool off.
Wanting to be able to bend over and tie my shoes without feeling winded.
Being introduced to people and wondering if they can see anything but my fat.
Wanting so badly to wear the current styles but only being able to shop at places that carry clothes large enough to fit me.
