troubles with insurance

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glaciergrl
Regular Member


Date Joined Apr 2005
Total Posts : 269
   Posted 8/11/2009 2:14 PM (GMT -6)   
I just got a new job and found out today that my new isurance will not cover my surgeon or anyone else at the hospital i go to. Quite honestly I just want to cry. They will coer 60% but when you look at procedures that is still leaving me with a hefty bill. I had complications with my surgery, in fact you know that small percentage that they always say probably won't happen to you...it happens to me! ALWAYS! I'm bad with statistics and numbers. I don't want to change doctors because I am such a complicated case with my uc (gone), psc, and the complications with my reversal.
 
Anyone have any advice? I'm pretty stuck.
I know this isn't exactly an ostomy questions but I know I can count on you guys.
25yrs old/ teacher/ Wisconsin

Diagnosed UC Pancolitis in Nov 2004
Diagnosed PSC in Oct 2006
 
Proctocolectomyand Jpouch formed with loop ileostomy April 2009
Reversal June 2009
 
 


suebear
Forum Moderator


Date Joined Feb 2006
Total Posts : 5692
   Posted 8/11/2009 3:47 PM (GMT -6)   
This is a bummer. Right after my surgeries my surgeon stopped taking insurance altogether which forced me to see another surgeon. I have to say, the switch hasn't been bad. Oh, I miss my surgeon. He gave me my life back and I will forever be grateful to him but the new guy is a good guy too. When you have more distance from the surgery, recovery, complications, you might see that another doctor can handle your case. I know it doesn't make you feel any better today, though.......

Sue
dx proctitis in 1987
dx UC in 1991, was stable until 1998

1998 started prednisone, asacol, pentasa, nortriptylene, ativan, 6MP, rowasa enemas and suppositories, hydrocortisone enemas, tried the SCD diet, being a vegetarian, omega 3s, flax, pranic healing, yoga, acupuncture, probiotics

2000 lost all my B-12 stores and became anemic

2001 opted for j-pouch surgery- now living life med-free


RobinByrd
Veteran Member


Date Joined Dec 2008
Total Posts : 511
   Posted 8/11/2009 6:49 PM (GMT -6)   

First of all...I hope you like your new job!  Secondly, that really is a bumb deal about your insurance.  I realize the 60% is not the ideal situation, so I am curious about a flexible spending cafeteria plan.  My employer puts in the same amount I do each month, and next year I'm going to have to up my monthly input to $60/mo to cover our health expenses.  I would hope that you have that option.  Maybe you could put in $100/mo and your employer may put in $100 as well, so that's $200 a month toward your expenses.  What do you think?  I adore my flexible spending with my company (they're being slow with my last reimbursement) but it's still a wonderful service to have. 

I wish you the best of luck, and I totally agree...changing doctors this far in the process and with your continued struggles would be down right scary!

smurf  


: )  Robin
 
29 year old Mommy of an amazing 1 year old and Wife for 2 years!
Dx-May 2007 Moderate/Severe Pancolitis - failed all medications
 
Proctocolectomy w/ permanent ileostomy on 02/06/09!!!
 
"Your mind is like a parachute, it only works when it is open."  -Unknown


XtremeMisery
Veteran Member


Date Joined Sep 2007
Total Posts : 687
   Posted 8/11/2009 9:27 PM (GMT -6)   
so sorry....I have had such a deal with insurance and I have good insurance being in the medical field. I was not covered for any of the testing I had in Cleveland or the botox injections I tried....it was so frustrating. I tried everything I could....I even had trouble getting zofran after surgery. I pray for your peace in all of this...I truly know how frustrating this is!!!
 
Lizzie
Chronic Lifetime Constipation, Dx IBS-C for 7 yrs
Diagnosed Colonic Inertia-Oct 2007
Total Colectomy with ileorectal anastamosis- Jan 28, 2008
Ileus with suspected leak- Feb 1, 2008, ended with four abdomal abscessses and 2 drains
Four abdominal abscesses- Feb 2008
Diagnosed with small bowel Fistula- March 6 2008
Drains removed- End of March 2008
Continued Constipation- biofeedback for 3 mo Aug 2008, Dx Rectal Inertia (Anismus)
Admitted with Small Bowel Obsruction April 4, 2009 and eremgency ileostomy 4/13
Loop ileostomy April 13, 2009 with abdominal abscess. Released 4/24
Cleveland Clinic twice for 3/4th referral. Possible reversal pending defecography July 31 in Cleveland.
 
"The Greatest Healing Therapy is Friendship and Love"


glaciergrl
Regular Member


Date Joined Apr 2005
Total Posts : 269
   Posted 8/12/2009 7:09 AM (GMT -6)   
I do not have flex spending, but that would be a wonderful solution! I think I'm just going to have to suck it up. I love my surgeon and my liver doc at that hospital. I also have a transplant doc there and Madison is the only place in WI that does live donor transplants, that reason alone is enough to stay in Madison. I'll have to see what I can find.

Thanks for you help!

Holly

and I am loving my new job so far!
25yrs old/ teacher/ Wisconsin

Diagnosed UC Pancolitis in Nov 2004
Diagnosed PSC in Oct 2006
 
Proctocolectomyand Jpouch formed with loop ileostomy April 2009
Reversal June 2009
 
 


Equestrian Mom
Veteran Member


Date Joined Mar 2008
Total Posts : 3115
   Posted 8/12/2009 6:13 PM (GMT -6)   
check with your insurance about your liver doc...sometimes when there is only one specialist in your area, your insurance might allow you to see them as if they were in your plan...it is worth asking!

glaciergrl
Regular Member


Date Joined Apr 2005
Total Posts : 269
   Posted 8/13/2009 7:22 PM (GMT -6)   
The supplementals won't cover me because i have all these pre existing conditions and most of them don't cover transplants, especially for a live donor transplant. I wish that they would allow me to still see my liver doc but there are others in the area. I go to UW-Madison for all my specialists and I just moved to Milwaukee. There are plenty of doctors and specialists in Mke I just don't want to switch because the surgeon, my liver doc, and my transplant doc are all working together on my case.

Thanks for all the suggestions. I think I will call anyways...

Holly
25yrs old/ teacher/ Wisconsin

Diagnosed UC Pancolitis in Nov 2004
Diagnosed PSC in Oct 2006
 
Proctocolectomyand Jpouch formed with loop ileostomy April 2009
Reversal June 2009
 
 

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