Re: Insurance vs. self pay

[Guest guest]

I have Partners Insurance (HMO). I only begun this process this week,

however my sister had the surgery in CT 3 yrs ago, with out delay from ins.

co. I do have the option to change coverage at the begining of the yr. Do

you think it is only your hmo or all in general?

Bolick

Employer Services A/R

Fax

Insurance vs. self pay

Hi

I have been hoping to have the MGB with Dr. since 2/19. I have

Cigna/HMO and was turned down due to an exclusion. I hired a lawyer

and appealed and still lost. I now have a complaint into the NC

insurance commisssion. I doubt that will change things. Another

twist with Cigna, is they also have a clause they states they will

not pay for any complications related to any surgery they did not

approve of or they excludes. That is why I could not be a self-pay,

just in case there were complications, a long term hospital stay or

additional surgerys would wipe us out. I couldn't take that chance.

Check your policy for that clause.

Now on a good note...With the help of my benefits manager we

researched the plans my company offers and I will be able to go have

surgery in January through CoreSource. This is because this is a

self funded plan my company offers. I don't know how many of you

have the option to change insurance plans yearly, if you do,

investigate them all. Thanks, , MGB hopeful, January looks good.

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[Guest guest]

I have been on this list since February and have learned that all

policys are different even if they are HMO's. Get a copy of your

contract and read what it says about weight loss. Also, since you

are out of state, you need to investigate if the insurance would pay

for you to go " out of network " . I have seen a some people get hung

up with that aftrer they were approved for surgery. Good luck to all

of us.

> I have Partners Insurance (HMO). I only begun this process this

week,

> however my sister had the surgery in CT 3 yrs ago, with out delay

from ins.

> co. I do have the option to change coverage at the begining of the

yr. Do

> you think it is only your hmo or all in general?

>

> Bolick

> Employer Services A/R

>

> Fax

>

>

> Insurance vs. self pay

>

>

>

> Hi

>

> I have been hoping to have the MGB with Dr. since 2/19. I have

> Cigna/HMO and was turned down due to an exclusion. I hired a

lawyer

> and appealed and still lost. I now have a complaint into the NC

> insurance commisssion. I doubt that will change things. Another

> twist with Cigna, is they also have a clause they states they will

> not pay for any complications related to any surgery they did not

> approve of or they excludes. That is why I could not be a self-

pay,

> just in case there were complications, a long term hospital stay or

> additional surgerys would wipe us out. I couldn't take that

chance.

> Check your policy for that clause.

> Now on a good note...With the help of my benefits manager we

> researched the plans my company offers and I will be able to go

have

> surgery in January through CoreSource. This is because this is a

> self funded plan my company offers. I don't know how many of you

> have the option to change insurance plans yearly, if you do,

> investigate them all. Thanks, , MGB hopeful, January looks

good.

>

>

> This message is from the Mini-Gastric Bypass Mailing List at

Onelist.com

> Please visit our web site at http://clos.net

> Get the Patient Manual at http://clos.net/get_patient_manual.htm

>

> To Unsubscribe Send and Email to: MiniGastricBypass-

unsubscribe (AT) egroups (DOT) com

[Guest guest]

TO ALL PEOPLE HAVING TROUBLE WITH YOUR INS. DOSE ANY OF YOUR PRIMARY DOCTORS

HELP YOU IN ANY WAY I WAS TURNED DOWN AND IT WAS MY PRIMARY DOCTOR THAT GOT

THEM TO CHANGE THERE DECISION I AM VERY THANKFUL TO HIM

[Guest guest]

> Another

> twist with Cigna, is they also have a clause they states they will

> not pay for any complications related to any surgery they did not

> approve of or they excludes. That is why I could not be a self-

pay,

> just in case there were complications, a long term hospital stay or

> additional surgerys would wipe us out. I couldn't take that

chance.

Hi,

I was self-pay and just wanted to give you the thoughts I had on

this. I figured if I got away with $20,000 or less that would be

great but if there were complications I would be paying (payments)

for the rest of my life... but at least I would have a life.

I was lucky... no complications... best decision I ever made.

Jane McShane

MGB 3/10/00

250/185