Question:
I am 2 months post op and changing jobs...

Has anyone done this post-op? How is it handled when you switch insurance carriers post-op? Anyone experience problems with doc visits or coverage?    — Kymberly H. (posted on November 12, 2003)

November 12, 2003
It really depends on your new insurance. Is it an HMO, where you have to use the plan's doctors? If so, is your surgeon part of the plan? If not, those visits won't be covered. If it's an HMO you also would need to get referred to visits to your surgeon by your PCP. Is the PCP willing to do this? If you're going to a PPO or a POS type plan, then you almost certainly can continue on with your surgeon without a problem. The only thing to be wary of here is if your surgeon is a "preferred provider" in the plan. If so, you get a better level of benefit. If not, you still have coverage, but at a lower level. You should not have any problems with pre-exisiting condition limitations as the new plan has to give you credit for the period of time you were covered by a previous group plan (as long as you didn't have a break in coverage greater than 62 days), So, assuming you had at least 12 months of coverage in your old plan pre-ex is not a problem. (Stop for breath...) So, it's likely not a problem, but there are few things to be careful of.
   — Vespa R.

November 12, 2003
My doc give us free follow-up office visits for 12 months, so it would not be an issue. He's already been paid with his surgery fee. Anything more involved like being scoped etc. is billed but not the regular check-ins. Are you sure it's not the same for you? You can have your PCP order the blood tests etc. so that it's all covered.
   — zoedogcbr

November 13, 2003
I work for a medical billing office, and here is what you need to do. You must get a certificate of continuing coverage from your current insurance, in order for your new insurance to cover anything that they would consider pre-existing. It's the law that the insurance has to provide you with that. Call them, and don't let them give you a hard time about giving it to you. You remember your fight with them to get the WLS surgery done in the first place, right? Well, you be just as tough on them regarding this issue. If the Rep gives you a hard time, ask to speak to a Supervisor, if she gives you a hard time, go to her Supervisor, and so on, right up till you get the CEO if necessary. Good luck!
   — Marina U.