Question:
Losing job and will have 2 months severance
As of today, March 14, 2002, my company is closing it's doors. I will have severance for 10 weeks (2 1/2 months). I have my initial consultation with Dr. Timothy Custer, Mt. Carmel Hospital, Columbus, Ohio, on Tuesday March 19, 2002. Anthem BC/BS (POS) hasn't approved surgery, yet, but they do cover at 100% with a $200 deductible if surgery is proven "Medically Necessary". I have done everything I can with my WONDERFUL PCP and his Certified Nurse Practioner. (Dr. Jeffery Hunter and Michelle Giovanelli--spelling??) up until now. The only thing left to do for Anthem, to approve the surgery, is a form with 5 questions that only the surgeon can fill out with me and send back to Anthem. HERE'S THE POSSIBLE PROBLEM.....Does anyone think that because my insurance is running out on May 25, 2002 (and I will need to find a job before then), that there may be a way to persuade Dr. Custer to not only approve me for the surgery, but get him to give me a surgery date in the next 4-6 weeks that will allow me recovery time and then time to find a new job? Has anyone ever dealt with the insurance ending problem? I used to have UHC of Ohio and they told me that they have NEVER approved WLS for anyone, but it didn't matter, because I lost my job on June 20, 2001. PLEASE HELP ME!! Thank you very much!! — rdszakacs (posted on March 14, 2002)
March 14, 2002
Hon, explain to the dr your situation, and if he could move the surgery
date up. The doors closed on myself and a friend of mine (we both had the
surgery) i had already had my surgery date for dec 18th and my insurance
was good till jan 31rst, but she was still in the process of getting
approval and needed a date, when she explained to the surgeon her situation
they moved her surgery up and she ended up only waiting a couple of weeks
took her by surprise but she was able to have it before the insurance ran
out.. good luck to you i wish you the best
— Deanna Wise
March 14, 2002
talk to your surgeon and explain - he may be able to work with you - you
may also think of taking on cobra - if your surgeon can work with you and
you can get by with cobra for a month it may work out for you - but be
honest and beg and plead :)
— Sharon Jones
March 14, 2002
I know it's spendy but another option could be to take out a COBRA policy
during the transition....with the severance package, it might be something
you could ask for as well. Just a thought ~ good luck !!
— Lisa J.
March 14, 2002
This doesn't really answer your question but I had surgery on 1/31. On 2/5
my company called me at home and "eliminated my job". All I can
say is I am glad I had the surgery while I still had my insurance. I know
my husband's insurance has denied the surgery to at least 2 people. It is
worth having the surgery and just think, you won't be in a rush to recover
and get back to work!
Good Luck in what ever you decide.
— dianehanson
March 14, 2002
COBRA may not be an option. If your employer is going out of business,
there won't be a group insurance plan for them to keep you on. I'm not
absolutely sure on this, but it seems like it wouldn't be probable for the
government to make an employer keep a group plan for 18 months after they
go out of business.
— garw
March 14, 2002
I was notified on Nov 29,2001 that my position at an Insurance Co. had been
"eliminated". My surgery was scheduled for 12/10/01 and
fortunately my insurance coverage did not end until 12/31/01 so I was able
to have my surgery as scheduled. I also have a weekend job but their ins.
plan does not cover wls. I would have paid Cobra payments if necessary to
make sure I could have my surgery. With Cobra there is no change in your
existing coverage and it is available for up to 18 months after a lay off
but it is expensive. Good luck.
— jsuggs
March 14, 2002
hi i had open r n y on feb 8 02 my company is closing its doors and moving
to china in june theres only a small number of us left and you never know
when its your last day they downsze periodically so you could be notified
at any time that your done but you get a 2month notice so were insured
until then i was really worried about this because i had finally made up my
mind to have surgery in november i thought for sure with bcbs knowing we
were closing that they would stall for months or surgery wouldnt get
scheduled fast enough i expained this carefully to both pcp and surgeon
also i had both docs fax numbers readily available to save time like after
i would have a preop test done id give them fax # to save time i did
anything i could to save time all went well referrals went fast tests went
fast i was approved for surgery in one week scheduled surgery was able to
have surger y within 2 weeks after scheduling i was prepared to go cobra if
i had too but so greatful all worked out best of luck to you :)
— carrie M.
March 14, 2002
Gar's reply regarding eligibility for COBRA Insurance is correct. If your
company is shutting down it is unlikely that it will be maintaining a group
insurance plan. FEAR NOT! Many states offer mini-COBRA for folks in your
situation or those from companies employing fewer than 20 people (those
tiny companies are exempt from COBRA). I found out some really good
information pertaining to this at:
http://www.insure.com/health/cobra.html. It's informative reading, and if
you scroll down to the bottom, you can find out the specfics of mini-COBRA
in your state. If there aren't any other options, this may buy you some
more time. Good luck!
— PaulaM
March 14, 2002
I was in the same situation. The company I work for is in Dire financial
trouble, and I did not expect to have my job by the time they could
schedule me for surgery 6 months down the road. I talked to my Doctors
schedulker, and laid averything out for her. I explained that if I am not
able to get in sooner they may not be able to do the surgery, because I
will not have insurance. she looked through their books, and found someone
had just cancelled that very morning for December the 14th, this was on
November 5th, so I got in, and had my surgery a month later. If I had lost
my job I definately would have persued Cobra, but I didn't want to have to
worry about recovery, and making my cobra payments, as well as looking for
a new job all at the same time. Forntunately my company did do some
restructuring, and I still have my job. We will now just have to see how
long I am able keep it...
— sbinkerd1
March 15, 2002
I am getting my surgery through COBRA. If it is available to you, you
should consider it. Your next job may have an insurance plan that is more
difficult to get to approve the wls. Also, our reason: The old plan is an
HMO, our out of pocket will be very minimal. My husband's new office
offers a different plan where we would pay $300 deductible PLUS 30% of ALL
charges. Makes the cost of the COBRA seem like chump change on this
surgery. Besides, as he is a contract employee, he's not eligible for the
new insurance for 6 months. Please e-mail me if you need any advice. If
you do COBRA, get the paper work started right away so you don't have any
lapse in coverage. It won't hurt your approval, just slows things down a
lot. Good Luck!
— cjabates
March 15, 2002
Rachelle, Dr. Custer was my surgeon. I would call the office and you need
to talk to Pam and tell her she needs to RUSH all of the information to
Anthem to get you approved as soon as possible. Tell her about your
situation. I would also tell her that you want to know WHEN she sends the
paperwork in so that YOU can call Anthem to follow up and find out when
they have approved you. I'd call after about a week and keep following up
every couple of days. Once approved, call Pam and let her know of the
approval and AGAIN stress the importance of getting a quick surgery date
due to the insurance terminating. She should then get a surgery date for
you. I work with someone who's wife has Dr. Custer doing her surgery on
Monday and she had to wait a month for a surgery date. Good luck and if
you have any questions on Dr. Custer or Mt. Carmel West, let me know.
— Patty H.
March 15, 2002
Another suggestion to keep things moving. You might want to get all the
paperwork from your doctor and send it to your insurance yourself. Send it
registered mail, return receipt requested. That means someone has to sign
for it, and then the Post Office will return the receipt to you so you will
KNOW they did get it. Can't hurt and might even help.
— garw
March 15, 2002
Rachelle, just a follow up, I had my 3 month check up with Dr. Custer
yesterday and happened to mention your predicament. He said that you
should DEFINATELY say something to HIM about it when you come in and he
would try and get things arranged as soon as possible.
— Patty H.
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