Re: Question for Judie Hensel

[Guest guest]

In a message dated 9/17/2001 10:19:56 AM Pacific Daylight Time,

joostema@... writes:

> If it is a law, is it only intended to

> aid people

> on medicare, or would it apply to everyone in that state ? How would I go

> about finding out if medicare pays for WLS in my state ? If I find that it

> does,

> how do I find out if the law then forces all insurance companies to cover

> it

> as well ?

>

Donna...

In Washington the state doesnt mandate insurance regarding what Medicare pays

for UNLESS you have Medicare and they are secondary. I have sent letters to

the state capital expressing my anger over the fact that people without

insurance and covered by the state are getting surgery paid for but people

like me that work and have insurance and should get AT LEAST what Medicare

and DSHS covers. Not to put anyone down on disability or anything but it

really isn't fair.

~*~ AJ ~*~

Age 37 5'8''

Post op 7/24/01 Open BPD/DS

self pay - Dr Baltasar -Alcoy Spain

07/24/01 BMI 64 415.1

08/06/01 BMI 59 390.2 -24.9 lbs!

08/16/01 BMI 58 387.0 -27.9 lbs!

08/24/01 BMI 58 386.5 -28.6 lbs!

08/30/01 BMI 58 378.3 -36.8 lbs!

09/10/01 BMI 56.7 373.0 -42.1 lbs!

[Guest guest]

>> Since medicare approves the DS, its the reason it was overturned. We

knew

>> that and even the insurance man told us that anything medicare pays for

by

>> law insurance has to pay too. We even told Regence that but they

played

Judie,

Hi !! I'm not on medicare, but was wondering if you knew if this is a law

in all

states (I'm in North Carolina) ? If it is a law, is it only intended to

aid people

on medicare, or would it apply to everyone in that state ? How would I go

about finding out if medicare pays for WLS in my state ? If I find that it

does,

how do I find out if the law then forces all insurance companies to cover

it

as well ?

I guess what I'm saying is ... 'help' !! )

Any info you've got the time to share would be much appreciated ... getting

ready to battle with Cigna next month, after seeing Dr. Hess, and anything

to smooth the bumpy road I'm about to embark on would be very helpful !

Thanks and hugs,

Donna

[Guest guest]

> Hi !! I'm not on medicare, but was wondering if you knew if this is a law

> in all

> states (I'm in North Carolina) ? If it is a law, is it only intended to

> aid people

> on medicare, or would it apply to everyone in that state ?

Hi Donna......medicare is federal so its a federal law and it applies only

to those on medicare. Federal law covers ALL states.

How would I go

> about finding out if medicare pays for WLS in my state ?

Federal law covers all the states the same way......if it covers wls in

Idaho it covers it in NC......doesnt matter which state you live in.

If I find that it

> does,

> how do I find out if the law then forces all insurance companies to cover

> it

> as well ?

If you are on medicare it only pays 80% of the allowable charges....then if

you have supplemental insurance which you must pay for out of your own

pocket also, then the supplemental is required by law to pick up what

medicare does not pay. (the 20% medicare doesnt pay) otherwise if you

dont have supplemental you must pay that 20% yourself.

>

Hope this helped a little bit in understanding how it works.....if you

qualify for disability you qualify for medicare (if you have worked long

enough to collect it)

Judie