slow progress yet quickly?

I have two calls today with two different therapists for 2nd letter. In actuality it doesn't matter which one I choose. I still feel better having a 15 minute free call to discuss expectations and see if I can relate to the therapist before paying for an hour or so. I mean, they aren't going to be my primary therapist so it's a one-off. Still, I'd rather be comfortable with them as a person before I answer a bunch of personal questions.

Surgeon is already in touch with my nephrologist to clear me for surgery. Next Tuesday I have a Dr appointment for all the physical checkups required. How'd they put it  .. "Primary care evaluation and risk stratification for surgery"

Insurance .. *GASP* .. they checked with my insurance and say that it's covered 100%. I find it difficult to believe that the hard exclusion was removed but if that's the case I am more than happy to not pay the full cost out-of-pocket. Yes, I was/am prepared to do that.

In other news  .. yeah, I got nothing. This is taking up most of my mental space right now. The whole gambit of emotional twists and turns. The worst is expecting an anvil to drop and not be able to proceed.

Hi Faith,

Good luck in getting everything approved for surgery.

Marion

Hi Faith

Best wishes for the future and I hope you get the ok for surgery to go ahead.

Kind regards and hugs
Sarah B

Quote from: Faith on February 16, 2024, 06:14:38 AMSurgeon is already in touch with my nephrologist to clear me for surgery.

We're so excited for you! Hugs to your wife for giving you the needed kick in the butt.

QuoteIn other news  .. yeah, I got nothing. This is taking up most of my mental space right now.

We understand.

I just finished a full morning of prerequisite testing that the surgeon wants before even considering scheduling. So far no red flags. They actually expidited the tests for me. Full physical, ekg, xray, bloodwork. I should have final results within a week.

This afternoon is both therapists specifically for my letters.

I am sure you will fly through. XXX

This is the part of the process that make me the most nervous. Waiting for others to give me permission to do what I want to do. I realize they just want to make sure I'm healthy enough to have certain procedures, but it always makes me really anxious. I hope all of the test results added together result in an approval.

Love always -- Jessica Rose

Two therapist letters down. Awaiting pee and blood test results. I know it'll be a bit abnormal but hopefully not to the point of stopping surgery

@Faith
Dear Faith:

I am eagerly looking forward to your next and latest update...

HUGS, Danielle 

Now the gangs together, welcome to the basement. Pull up a chair and stick some tunes on.

Quote from: davina61 on February 22, 2024, 02:36:02 PMNow the gangs together, welcome to the basement. Pull up a chair and stick some tunes on.

I could use me some Tennessee Whiskey 😜


Not much to update. I have my letters and medical clearance. The surgeon submitted it to insurance for pre-approval. They responded with the generic "is this medically necessary" *sigh*

No real update. Insurance Specialist at surgeons office emailed. It can take 2-3 weeks before receiving an approval or denial response. My impatience is increasing steadily at this point. I waited for years, what's a few weeks?  arrrggghhhh

One of my favorite Susan's Place quotes -- 'I want patience, and I want it now!'

Good luck, Faith!

Love always -- Jess

So, the answer is as I expected: Denied by explicit policy exclusion. It doesn't change that fact that I am disheartened. I fought all day yesterday not to cry about it, it hit me hard.

I still don't have a self-pay price from the place. They kept giving me a non-answer of 'waiting on insurance' or 'prohibitively expensive'. How do I know, or they know, if it's out of my self-pay range if they don't tell me what it is? I have money put away expecting to pay upfront.

life sucks

Sorry that they keep denying your giving you non response. I hope that changes soon for you. Hugs
Mariah

Unless something drastic and unexpected happens, it looks like surgery is out.

Still explicitly excluded in our insurance policy - They get away with it because it's a fully company self-funded plan. It is the only explicit exclusion in the policy.

I can't do self pay. The surgeon I was working with charges 75k. While I could do it out of pocket, I cannot in good conscience take those funds away from the household. Besides the fact that the surgeon refuses to take self-pay. Their answer was "oh, it's just 8 months, wait until open enrollment and get a good insurance policy" .. at 2k a month? Yeah, right.

So sorry you have to deal with this Faith. Insurance companies are nothing but legal fraud companies. I get a book from my insurance explaining the policy every year. It might as well be written in a foreign language for all I can understand of it.
Stay strong Faith. When one door closes, another one opens.
Hugs Gina

Insurance policies have their own dictionary, where commonly known words have altogether different meanings.  It is outrageous.  They should be required to write policies in plain English/Spanish whatever. 

Faith, $2,000 a month is a LOT cheaper than $75,000 at once.  Of course, you'd probably still have a deductible/co-pay.  Hopefully, insurance makes it affordable for you. 

@REM.1126  ...  The bulk sum is in our retirement portfolio.  2k/mo would come out of our monthly household income. Neither is an equitable solution as it has detrimental impacts.

Have you looked into different insurance companies or other funding sources? I did a Google search, once upon a time, and there was an insurance company (Minnesota, I think) that covers surgery and other care. Granted your premiums would be out of pocket, but certainly less than $2k/month. I also found various organizations that offer grants and loans specifically for surgeries. I don't know what it takes to qualify but sources are available. Don't lose hope (have Faith!)