Medfet's Weblog

Medical Fetish Fun and Fantasy

Health insurance is only as good as what it will actually cover…

I usually limit my blogs and posts to funny things or quirky things or just comments and photos in general that just are meant to poke a sleeping bear and spark some conversation.  I’m going to take a little different approach for this post and do a little ranting.  For those of you that know me very well I’ve been researching and contemplating weight loss surgery off and on for a good 5 years now.  I’ve recently started down the path of moving forward and getting the ball rolling.  It’s not an easy path, or a fun one, or even one that lets you feel any kind of emotional relief anywhere before or soon after any surgery.  But it’s one that has to be done for who are in my category of morbid obesity.

The biggest hurdle I thought would be just the mental barrier of making that first step and getting things going.  Little did I know it was going to be the health insurance that I carry.  I have a policy that was offered by my previous employer.  Like anyone else my costs went up while I was in that plan, services went down, and interaction with the provider got more and more different.  I had looked into what my coverage was for weight-related issues in general last week and found that pretty much everything is excluded, specifically weight loss surgery.  Funny thing is I bet they’ll cover stuff like Viagra and certain cosmetic procedures.  I didn’t let that stop me too much since it was just a cursory quick check with the insurance and I hadn’t even been to talk to the surgical group that would be doing the surgery yet.  I figured when I went to meet with them for the first time I’d get the specifics on how to request that kind of coverage, who to ask for, etc….

I attended one of the small seminars the surgical practice offers to familiarize potential patients with the specifics of the various procedures as well as all of the things you need to take care of for the benefit of the insurance providers.  I even was approached by the administrator of the practice that traditionally they have difficulties with United Healthcare.  I took this into account today when I sat down to call my insurance provider again.  This time I was armed with billing and diagnosis codes as well as knowing to ask for a specific case manager and not just the first representative that answers the phone.  I dialed the number, again pleased by how fast I got through to someone.  After doing the typical song and dance to verify who I am I get right to the point.  Knowing they said they don’t cover it wasn’t really deterring me perhaps the way it should have.  I felt somewhat optimistic that, having armed myself with the right information and the right procedure, I’d get somewhere.  Well, in short… I GOT NOWHERE.

So where does that leave all of this?  Well, no farther along than where I started I suppose.  I can’t even comprehend going on such an epic journey without the support of friends and family and especially those people that I’ve been faithfully paying bills to for several years now.  But that doesn’t change the fact that I’m here, with no one interested in even knowing what this is all about or discussing it, and with an insurance provider that won’t pay the bills.  Not even part of them!  So, pay with cash perhaps?  I’m sure that’s a possibility but I can’t even begin to imagine what kind of questions that brings up or what kind of unforeseen situations it might breed.

Thanks for listening to my rant.  It’s rare that I ask for someone to understand how something makes me feel but generally I feel like why bother if no one asks ahead of time.  Comment if you will.

March 4, 2011 - Posted by | Life, Rants | , , , , , , , , , , ,

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