Pick myself up from my boot straps and stay motivated!!!

[Guest guest]

Hi Everyone!!!

I was feeling sorry for myself all week and sent some down and out

posts. It has been almost 7 months since I started this process. I

decided to pick myself from my bootstraps and move on. After reading

Kathy's post about self insurance, I called my Benefits person who

has been helping me out. She told me one of the plans I can switch

to in November is CoreSource a self-insured plan. She told me she

has been speaking to the appeals committee ( I guess they look at all

claims) they said from what DR. R. has written so far they see no

reason why I will be denied. She read me the clause regarding WLS

surgery and it is excluded " except when deemed medically necessary

for morbid obesity treatment " . I feel really good about this. She

told me that after my 250.00 deductible they will pay at 90% of the

reasonable and customary fee. I told her that Dr. R's surgery is the

least expensive WLS out there so I feel comfortable that he will not

exceed the reasonable and customary fee. Does any one know what is

considered reasonable and customary? It is almost September, so I

figure I have 4 months to get everything together. Can I send in my

packet prior to switching insurance companies requesting a January

date?

Do you think I am getting my hopes up too soon? What do you guys

know about indemnity plans. This sounds like what I need. My

benefits person is going to get it in writing for me that I will be

covered before I change. I just have to stay below the 350lb mark.

This will give me the incentive. January doesn't seem so far away

now. Thanks for letting me ramble.

Yeah, Rozycki, Denver, NC, BMI 53, Waiting since 2/19 looks

like I will be able to go in January.