Wednesday, December 28, 2011

Update on Revision Surgery

I've been waiting to hear from the doctor about the "peer to peer" appeal he was going to do with my insurance company.  In being patient with the holidays and bureaucracy, I was going to wait to call until after the New Year, but I received a phone call this morning!  Unfortunately, it wasn't good news.  Because my insurance plan doesn't offer any bariatric/complication coverage, they are refusing to cover any revision or removal of my LapBand.  Awesome!  The quote given to me from the doctor (depending on where he'll be able to do the surgery) ranges from $13k to $17.5k.  Sure - let me pull that out of my pocket!  Get a loan you say?  Sure - my credit is perfect for that!

Blah.  I miss my old insurance with my old job - I've paid more out of pocket for barium swallows, check ups, medication (Chantix) etc. in the 5 months that I've had this job than I paid in the entire eight years at my old job.  And what kind of company doesn't provide bariatric coverage nowadays?  Really?

Get this - the insurance company also told my doctor that if my issues got to the extreme where I get so stuck I have to be admitted for emergency removal (a repeat of early October, but this time with no fluid to drain from the band)?  That wouldn't be covered either.  Eff this.

So what's my daily life like at this point?  Well, if I eat really small bites and graze all day long - never have an actual meal - I get by okay.  If I attempt a meal, it's going to either (a) be manually regurgitated or (b) remain so lodged in my body that three symptoms occur: my chest is tight/hurts, my back hurts and I get really cold (from the inside out).  Can't figure out why my back hurts or I get cold, but my boyfriend is sure getting used to my symptoms as I spend this vacation at his house!  To eat and be in pain, or not to eat and be hungry...that is the constant question I deal with.

On the plus side, I HAVE quit smoking!  Today marks two solid weeks of no cigarettes, although my actual quit date was a month ago (I slipped and had a cig now and then in the first couple of weeks).  I'm still craving the habit/nicotine - which makes me want to eat = get sick - but the thought of the taste of a nasty cig deters me enough not to go out and buy a pack.  Even in those two weeks of rarely smoking, the cig did nothing for me (I was on Chantix then) and they tasted gross and made my stomach hurt.  Don't know why I bothered to smoke at all...that's when I decided 2 weeks ago to stop completely.  I'm no longer on Chantix, but am doing great!

5 comments:

  1. Joia - I am so sorry to hear that. It totally sucks. I don't understand how they can pay to put it in, but refuse to take it out in even an emergency situation? My mom and sister are in a similar situation with no insurance and no $$ b/c they lost jobs. They both have the band and are unable to have fills or tests needed to maintain it. I wish they would educate us on these possibilities before we had the surgery.

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  2. Joia I am so sorry you are going through all this. (((hugs))

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  3. I am very happy to hear that you have quit smoking :o) I know it takes a lot to quit, so well done and keep up the great work!!

    Now onto your band, I am so sorry to hear that you are having so much trouble!!! I am thinking of you and am sorry that I can only hope that the situation somehow improves!!

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  4. Ughh..I'm so sorry you're going through this! Good job on quitting smoking!!!

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  5. The situation our insurance puts us in when things like this happen is just terrible! My insurance covered most of my removal, but I am still working on paying off the $2,000 that I was billed. It is like a stab in my heart every month when I have to send another payment off. I hope you are able to find a solution and have your band safely removed. I appealed to my insurance to revise to sleeve but I was also denied. I'm sending positive thoughts for us to both have a much better 2012 and that we are all able to reach our health goals. Hang in there!

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