Guest guest Posted February 12, 2006 Report Share Posted February 12, 2006 <That said, I believe that the coverage of pre-existing conditions applies to the employee only and in many cases the spouse may have to wait. > Fortunately I didn't have to wait at all for mine to kick in. It is my husband's policy through work. It covers my diabetes testing supplies 100%, I have a $30 co pay on my insulins, and a $20 co-pay on each doctor visit. They pay 100 % on all blood work. Duckie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2006 Report Share Posted February 12, 2006 Also you need to have continual coverage with no lapse. If there is a lapse (even 1 day)in coverage, when offered group insurance at a new job, they can still pre-exist you, but I don't think they can deny coverage totally on group. So you'd get the coverage, but they would pre-exist for 12-18 months on diabetes or whatever you were being treated for. That's why it's critical to COBRA on to your former insurance or obtain private coverage between jobs. Obtaining private would probably be difficult with diabetes so COBRA, even at huge rates, becomes the solution. > > I know that if you work for a company and they offer insurance under a group > insurance policy then they will cover pre-existing conditions, but from what > I understand, only if it is a group policy. > > > Insurance > > I have a question on insurance not covering pre-existing conditions. I know > that several years ago insurance wouldn't cover anyone with pre-existing > conditions and had a friend who had a heart transplant. A couple years > later she got a new job and had to change insurance. She said that they had > passed a law that insurance could not refuse to pay for pre-existing > conditions then (she couldn't have gotten ANY insurance if they refused > pre-existing conditions). > > What happened to that? Or was she making up another lie? > > Darlene > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2006 Report Share Posted February 12, 2006 Also you need to have continual coverage with no lapse. If there is a lapse (even 1 day)in coverage, when offered group insurance at a new job, they can still pre-exist you, but I don't think they can deny coverage totally on group. So you'd get the coverage, but they would pre-exist for 12-18 months on diabetes or whatever you were being treated for. That's why it's critical to COBRA on to your former insurance or obtain private coverage between jobs. Obtaining private would probably be difficult with diabetes so COBRA, even at huge rates, becomes the solution. > > I know that if you work for a company and they offer insurance under a group > insurance policy then they will cover pre-existing conditions, but from what > I understand, only if it is a group policy. > > > Insurance > > I have a question on insurance not covering pre-existing conditions. I know > that several years ago insurance wouldn't cover anyone with pre-existing > conditions and had a friend who had a heart transplant. A couple years > later she got a new job and had to change insurance. She said that they had > passed a law that insurance could not refuse to pay for pre-existing > conditions then (she couldn't have gotten ANY insurance if they refused > pre-existing conditions). > > What happened to that? Or was she making up another lie? > > Darlene > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2006 Report Share Posted February 12, 2006 Also you need to have continual coverage with no lapse. If there is a lapse (even 1 day)in coverage, when offered group insurance at a new job, they can still pre-exist you, but I don't think they can deny coverage totally on group. So you'd get the coverage, but they would pre-exist for 12-18 months on diabetes or whatever you were being treated for. That's why it's critical to COBRA on to your former insurance or obtain private coverage between jobs. Obtaining private would probably be difficult with diabetes so COBRA, even at huge rates, becomes the solution. > > I know that if you work for a company and they offer insurance under a group > insurance policy then they will cover pre-existing conditions, but from what > I understand, only if it is a group policy. > > > Insurance > > I have a question on insurance not covering pre-existing conditions. I know > that several years ago insurance wouldn't cover anyone with pre-existing > conditions and had a friend who had a heart transplant. A couple years > later she got a new job and had to change insurance. She said that they had > passed a law that insurance could not refuse to pay for pre-existing > conditions then (she couldn't have gotten ANY insurance if they refused > pre-existing conditions). > > What happened to that? Or was she making up another lie? > > Darlene > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 20, 2006 Report Share Posted October 20, 2006 , A physician supervised diet is pretty standard practice for insurance companies with WLS. I explained to my PCP that I had dieted for about 8-12 months a few years ago and lost a good 100lbs. Fantastic right?! I gained it all back plus probably another 50lbs. Hmm, not so good. She felt that was sufficient and signed off on my application. If you haven't dieted to that extreme or length of time you should, under the care of a physician of course. If you have and were unsuccessful explain that to your PCP/Surgeon and see what they say. If they're insistant that it be through them and with them and all that jazz then you may end up having to do it. It's probably only six months. Six months is chump change compared to a healthy life. Dieting sucks but so does having to have surgery and neither of those is as bad as being morbidly obese. Don't give up on getting healthy when an obstical gets put in your way. Your long term health is much more important than some pain in the ass diet or delay in getting WLS. I'm assuming once you've met the requirements for a diet you should be able to resubmit you request to your insurance company. Good Luck! Mike in GR > > I received a letter from insurance today denying my request for sugery. > UGH! I callled the surgeon's office. Insurance decided I needed to do a > physician supervised diet. Nothing was ever said about this before. I'm > quite frustrated! > > > > _________________________________________________________________ > Add a Yahoo! contact to Windows Live Messenger for a chance to win a free > trip! > http://www.imagine-windowslive.com/minisites/yahoo/default.aspx? locale=en-us & hmtagline > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 20, 2006 Report Share Posted October 20, 2006 , A physician supervised diet is pretty standard practice for insurance companies with WLS. I explained to my PCP that I had dieted for about 8-12 months a few years ago and lost a good 100lbs. Fantastic right?! I gained it all back plus probably another 50lbs. Hmm, not so good. She felt that was sufficient and signed off on my application. If you haven't dieted to that extreme or length of time you should, under the care of a physician of course. If you have and were unsuccessful explain that to your PCP/Surgeon and see what they say. If they're insistant that it be through them and with them and all that jazz then you may end up having to do it. It's probably only six months. Six months is chump change compared to a healthy life. Dieting sucks but so does having to have surgery and neither of those is as bad as being morbidly obese. Don't give up on getting healthy when an obstical gets put in your way. Your long term health is much more important than some pain in the ass diet or delay in getting WLS. I'm assuming once you've met the requirements for a diet you should be able to resubmit you request to your insurance company. Good Luck! Mike in GR > > I received a letter from insurance today denying my request for sugery. > UGH! I callled the surgeon's office. Insurance decided I needed to do a > physician supervised diet. Nothing was ever said about this before. I'm > quite frustrated! > > > > _________________________________________________________________ > Add a Yahoo! contact to Windows Live Messenger for a chance to win a free > trip! > http://www.imagine-windowslive.com/minisites/yahoo/default.aspx? locale=en-us & hmtagline > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 20, 2006 Report Share Posted October 20, 2006 , I'm so sorry to hear that. It sounds terribly disappointing. Did they give time frames for how long they want you on a physician supervised diet? What did your doctor say about the response? Is there hope for an appeal? insurance I received a letter from insurance today denying my request for sugery. UGH! I callled the surgeon's office. Insurance decided I needed to do a physician supervised diet. Nothing was ever said about this before. I'm quite frustrated! ____________ _________ _________ _________ _________ _________ _ Add a Yahoo! contact to Windows Live Messenger for a chance to win a free trip! http://www.imagine- windowslive. com/minisites/ yahoo/default. aspx?locale= en-us & hmtagline Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 20, 2006 Report Share Posted October 20, 2006 , I'm so sorry to hear that. It sounds terribly disappointing. Did they give time frames for how long they want you on a physician supervised diet? What did your doctor say about the response? Is there hope for an appeal? insurance I received a letter from insurance today denying my request for sugery. UGH! I callled the surgeon's office. Insurance decided I needed to do a physician supervised diet. Nothing was ever said about this before. I'm quite frustrated! ____________ _________ _________ _________ _________ _________ _ Add a Yahoo! contact to Windows Live Messenger for a chance to win a free trip! http://www.imagine- windowslive. com/minisites/ yahoo/default. aspx?locale= en-us & hmtagline Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 20, 2006 Report Share Posted October 20, 2006 , I'm so sorry to hear that. It sounds terribly disappointing. Did they give time frames for how long they want you on a physician supervised diet? What did your doctor say about the response? Is there hope for an appeal? insurance I received a letter from insurance today denying my request for sugery. UGH! I callled the surgeon's office. Insurance decided I needed to do a physician supervised diet. Nothing was ever said about this before. I'm quite frustrated! ____________ _________ _________ _________ _________ _________ _ Add a Yahoo! contact to Windows Live Messenger for a chance to win a free trip! http://www.imagine- windowslive. com/minisites/ yahoo/default. aspx?locale= en-us & hmtagline Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 20, 2006 Report Share Posted October 20, 2006 Not to worry it is part of the games that insurance companies play. I had to be on a 6 Mo. diet, did it, did not loose any weight, but made the insurance company happy. Wang wrote: , I'm so sorry to hear that. It sounds terribly disappointing. Did they give time frames for how long they want you on a physician supervised diet? What did your doctor say about the response? Is there hope for an appeal? insurance I received a letter from insurance today denying my request for sugery. UGH! I callled the surgeon's office. Insurance decided I needed to do a physician supervised diet. Nothing was ever said about this before. I'm quite frustrated! ____________ _________ _________ _________ _________ _________ _ Add a Yahoo! contact to Windows Live Messenger for a chance to win a free trip! http://www.imagine- windowslive. com/minisites/ yahoo/default. aspx?locale= en-us & hmtagline Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 20, 2006 Report Share Posted October 20, 2006 Not to worry it is part of the games that insurance companies play. I had to be on a 6 Mo. diet, did it, did not loose any weight, but made the insurance company happy. Wang wrote: , I'm so sorry to hear that. It sounds terribly disappointing. Did they give time frames for how long they want you on a physician supervised diet? What did your doctor say about the response? Is there hope for an appeal? insurance I received a letter from insurance today denying my request for sugery. UGH! I callled the surgeon's office. Insurance decided I needed to do a physician supervised diet. Nothing was ever said about this before. I'm quite frustrated! ____________ _________ _________ _________ _________ _________ _ Add a Yahoo! contact to Windows Live Messenger for a chance to win a free trip! http://www.imagine- windowslive. com/minisites/ yahoo/default. aspx?locale= en-us & hmtagline Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 20, 2006 Report Share Posted October 20, 2006 Not to worry it is part of the games that insurance companies play. I had to be on a 6 Mo. diet, did it, did not loose any weight, but made the insurance company happy. Wang wrote: , I'm so sorry to hear that. It sounds terribly disappointing. Did they give time frames for how long they want you on a physician supervised diet? What did your doctor say about the response? Is there hope for an appeal? insurance I received a letter from insurance today denying my request for sugery. UGH! I callled the surgeon's office. Insurance decided I needed to do a physician supervised diet. Nothing was ever said about this before. I'm quite frustrated! ____________ _________ _________ _________ _________ _________ _ Add a Yahoo! contact to Windows Live Messenger for a chance to win a free trip! http://www.imagine- windowslive. com/minisites/ yahoo/default. aspx?locale= en-us & hmtagline Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 20, 2006 Report Share Posted October 20, 2006 , Im sorry you got the bad news, but this is very common. Most companies will want to see a serious effort on our part, which can include a supervised weight loss program.......Please don't feel like they just don't want to help you, it happens to allot of us. Just jump through the hoops, most of us had to do this as well.........Good luck Mike T insurance >I received a letter from insurance today denying my request for sugery. > UGH! I callled the surgeon's office. Insurance decided I needed to do a > physician supervised diet. Nothing was ever said about this before. I'm > quite frustrated! > > > > _________________________________________________________________ > Add a Yahoo! contact to Windows Live Messenger for a chance to win a free > trip! > http://www.imagine-windowslive.com/minisites/yahoo/default.aspx?locale=en-us & hmt\ agline > > > > We are a very active support group. > If the email becomes overwhelming, > please change your setting to NO EMAIL! > Please contact Group Creator > Robyn@... > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 20, 2006 Report Share Posted October 20, 2006 , Im sorry you got the bad news, but this is very common. Most companies will want to see a serious effort on our part, which can include a supervised weight loss program.......Please don't feel like they just don't want to help you, it happens to allot of us. Just jump through the hoops, most of us had to do this as well.........Good luck Mike T insurance >I received a letter from insurance today denying my request for sugery. > UGH! I callled the surgeon's office. Insurance decided I needed to do a > physician supervised diet. Nothing was ever said about this before. I'm > quite frustrated! > > > > _________________________________________________________________ > Add a Yahoo! contact to Windows Live Messenger for a chance to win a free > trip! > http://www.imagine-windowslive.com/minisites/yahoo/default.aspx?locale=en-us & hmt\ agline > > > > We are a very active support group. > If the email becomes overwhelming, > please change your setting to NO EMAIL! > Please contact Group Creator > Robyn@... > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 20, 2006 Report Share Posted October 20, 2006 , Im sorry you got the bad news, but this is very common. Most companies will want to see a serious effort on our part, which can include a supervised weight loss program.......Please don't feel like they just don't want to help you, it happens to allot of us. Just jump through the hoops, most of us had to do this as well.........Good luck Mike T insurance >I received a letter from insurance today denying my request for sugery. > UGH! I callled the surgeon's office. Insurance decided I needed to do a > physician supervised diet. Nothing was ever said about this before. I'm > quite frustrated! > > > > _________________________________________________________________ > Add a Yahoo! contact to Windows Live Messenger for a chance to win a free > trip! > http://www.imagine-windowslive.com/minisites/yahoo/default.aspx?locale=en-us & hmt\ agline > > > > We are a very active support group. > If the email becomes overwhelming, > please change your setting to NO EMAIL! > Please contact Group Creator > Robyn@... > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 20, 2006 Report Share Posted October 20, 2006 I'm sorry !!!!! BIG HUGS TO YOU!!!!! > > I received a letter from insurance today denying my request for sugery. > UGH! I callled the surgeon's office. Insurance decided I needed to do a > physician supervised diet. Nothing was ever said about this before. I'm > quite frustrated! > > > > _________________________________________________________________ > Add a Yahoo! contact to Windows Live Messenger for a chance to win a free > trip! > http://www.imagine-windowslive.com/minisites/yahoo/default.aspx? locale=en-us & hmtagline > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 20, 2006 Report Share Posted October 20, 2006 I'm sorry !!!!! BIG HUGS TO YOU!!!!! > > I received a letter from insurance today denying my request for sugery. > UGH! I callled the surgeon's office. Insurance decided I needed to do a > physician supervised diet. Nothing was ever said about this before. I'm > quite frustrated! > > > > _________________________________________________________________ > Add a Yahoo! contact to Windows Live Messenger for a chance to win a free > trip! > http://www.imagine-windowslive.com/minisites/yahoo/default.aspx? locale=en-us & hmtagline > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 20, 2006 Report Share Posted October 20, 2006 That sucks. Did they say for how long? W 380/288/160 s wrote: > I received a letter from insurance today denying my request for sugery. > UGH! I callled the surgeon's office. Insurance decided I needed to do a > physician supervised diet. Nothing was ever said about this before. I'm > quite frustrated! > > > > _ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 20, 2006 Report Share Posted October 20, 2006 That sucks. Did they say for how long? W 380/288/160 s wrote: > I received a letter from insurance today denying my request for sugery. > UGH! I callled the surgeon's office. Insurance decided I needed to do a > physician supervised diet. Nothing was ever said about this before. I'm > quite frustrated! > > > > _ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 25, 2007 Report Share Posted May 25, 2007 Hey all, Heard from my insurance today. They aren't going to cover the tests till Sept 9. So I have to wait till then to bee seen by the transplant doctors. It is all because this is considered a pre-exsisting condition. So I am waiting till then to have anything done. Whitfield Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 2, 2008 Report Share Posted November 2, 2008 Hi there Walt...please if you have access to a 'puter please let us know how you're doing! That's an awfully long time to be stuck in the 'Big House'... Do you have a support network? What do you do the pass the time for such a long stretch??????? What are they DOING to you????????????????????? Hope you're getting free SOON... Cheers, in Oz >> Just like everything els. If you notice the price at the store is > higher. Also the container is smaller. Everything soup cans are > smallerI. I have been in the Hospital since Sept 11. Havent done a lot > of shopping ok. Before I came in here I noticed shoup cans are smaller > 10 0z used to be 12. God bless us all Walt> Quote Link to comment Share on other sites More sharing options...
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