Tag Archives: insurance

Dealing With New Insurance, Etc.

So, I have to go see my primary care doctor next week and the week after that, the bariatric surgeon.  Since changing jobs, I had to jump through all kinds of hoops to make sure that I have the correct plan that covers both of my doctor’s offices and covers what I need it to cover.

I spent an hour on the phone arguing with the insurance company to make sure that I had everything lined up for my appointments.  Then I had to call both doctors and get the appointments moved around and all of the new information to them.  It was a hassle, but it’s done now.  I hate dealing with this stuff.

I had the same insurance for seven years.  I was pretty much on insurance auto-pilot.  I knew my plan.  I knew what I needed to do.  I knew how much to set aside every year in flex-spending to cover what I needed to have done.  Now I have to re-learn everything all over again with a whole brand new insurance company and a brand new plan.  What a freaking nightmare.

I think I have everything covered, though.  I see my primary care doctor on Tuesday.  Then I see the surgeon’s on the Monday after that.  It has been three months since I visited the surgeon.  I have not seen my primary care doctor since before the surgery.  She will be so shocked to see me.

I have to get some blood-work done for the surgeon’s office and I also will probably have to get some basic blood-work for my doctor as well.  My workplace did a blood screening recently and my numbers were pretty good.  Cholesterol – normal.  Triglycerides – normal.  Good cholesterol – a tiny bit low.  Blood sugar – normal.  So, yeah everything is looking much better than it did 6 months ago.  I am going to take those test results with me to my doctor.  I will have my regular preventative care check up in July.

Wish me luck.

Five

Five days until my surgery.  Do I have enough topics to write about until then?  I’m sure I can come up with something.

I talked to the doctor who did the endoscopy and colonoscopy.  Good news.  No H pylori, no celiac disease, and nothing that would prevent me from getting the surgery.   Thank goodness.  Now, I just need to get them to send the pathology  information to the surgeon.

I hate having to hunt down information.  I had to go to my doctor to get copies of my chest x-rays to the surgeon’s office.  Then I had to chase down the GI doctor to get results.  This whole process has been an oddessey.  I understand the necessity of all of these tests, but sometimes chasing down test results and running from doctor to doctor is really irritating.  That said, it is good to know that so far, nothing major is wrong with me that cannot be fixed ask I lose weight.

Seriously though, if you are considering weight loss surgery, prepare  yourself for a lot of doctor’s appointments.  More than you think. Here are some things to consider that I have learned along the way:

  • Plan a year in advance before the surgery.
  • Purchase short-term disability insurance.  My employer offers it and it is inexpensive.
  • Short-term disability pays only 60% of your paycheck, but it’s better than zero if you run out of vacation time.  Check your employer’s plan’s policy.
  • Purchase supplementle insurance.  I did not, but if you’re concerned about expenses and covering for time off, you could consider it.  Figure out how much you would pay vs they money you think you might need.  If the insurance is more than what you think you need, set the money aside in a savings account instead.
  • Set aside as much as you can in your flex-spending account.  I did $2,000, which is about $76.00 per pay check based on 26 paychecks a year.  The money is taken out pre-tax, so it was not as big of a hit as it looks.  The peace of mind in paying insurance co-pays and prescription drugs co-pays was well worth it.
  • Many leave of absence requests only allow you to use the time you have accrued so far that year.
  • Save your vacation and sick time for your leave of absence if you can.
  • Purchase a week’s vacation if your company allows for that.
  • If your company allows you to  roll over vacation/sick/personal time, plan ahead and save some of your time from the year before.
  • Check your insurance plan and make sure you use doctor’s that are covered by your insurance.
  • Make sure the doctors you use obtain the correct pre-approval for all the tests you will need.
  • Ask your surgeon if anyone is assisting them and if there are additional costs.
  • Check with your insurance company to find out if they cover assisting surgeons.

I have to say, I am very lucky.  My employer has been fantastic about everything.  Everyone from my manager on up the leadership chain of command have really been cheering me on.  Some of them even occasionally read my blog.  I have also been very open with them about everything I am doing.

I work for a very large corporation with a lot of employees, but I really do feel that my leadership is truly concerned about my health.  Of course, if my health is good, I show up to work more often, I work harder and more effectively, and I bring positive energy to my job.  I know that they want to see that.  But I do also feel that my boss and his boss really care about me personally.  There might be aspects of my job I do not like, but that comes with any job.  Nonetheless, I do feel valued and they have really worked with me this year with all of the surgery preparation and my leave of absence.

So, my advice is plan ahead and prepare.  Prepare yourself by planning your time off for both the leave of absence and doctor’s appointments.  Prepare your insurance and money ahead of time.  And prepare your employer as well.  You’re not required to tell them everything or be as open as I have been, but if you at least talk to your immediate supervisor or someone in management that you trust, that way they can be prepared and may be more supportive.

Surgery Update

I have to admit, I am getting a bit anxious about the surgery.  I have been planning for it for a long time, but until now it was theoretical, off some time in the nebulous distance.  Not anymore.  I have a tentative date and the countdown can officially begin.

Then yesterday, I received a phone call from the surgeon’s office.  The insurance company denied the claim.  The guy at the surgeon’s office assured me that this is becoming standard with the insurance company.  They deny the claim and give you another hoop to jump through.

The insurance company wants a letter from my primary care doctor saying that I am medically cleared for surgery.  My doctor already supplied a letter saying that I am a good candidate for the surgery.  She won’t do the “medically cleared” letter until we do a pre-op appointment.  I have an appointment for Monday.  I do not know what she is going to require.  Will I need more tests?  I do not know. I guess I will find out on Monday.

The surgeon’s office assured me that once they have that letter, they should get the insurance company’s decision overturned in a day or so.  We shall see.

Once the surgery is approved, I will then only need to do a pre-op with the nutritionist and then take a class on how to eat after the surgery, plus anything else the surgeon’s office will require.

For now, we have not changed the surgery date.  We are still on track for the end of September.

Today’s cat picture is of my former cat Pounce de Lyon.  I know, cute name.  Friends of mine found him as a kitten, nursed him to health and gave him to me as a present.  I had him for many years.  He was an awesome cat.  He was so beautiful and very friendly.

When I first got him, he attacked everything and everyone.  When I had guests over, he would get so jealous of them, he would try to bite them.  I had to put him in my bedroom when I had visitors.  Then my sister brought home two kittens.  He fell hopelessly in love with the female cat and became putty in her hands.  This mellowed him out quite a bit and he became much more affectionate.  He was always affectionate with me, just not with strangers.  Once he mellowed, he loved everyone.

My cousin came to visit, and Pounce ran into the room to greet him.  Pounce jumped into his lap, meowed, and laid down so that he could pet him.  At which point my cousin asked if this was the same cat as before.

The gargoyle and dragon belong to my sister.  She loves that kind of stuff.  Pounce used to love to curl up next to this dragon and pretend to be stalking.