Monday, May 19, 2008

You Take The Good. You Take The Bad...

You take them both and there you have... the fact of life. The facts of life.

Okay, so it's obvious I watched way too much tv in my day. For those of you who were actually out 'playing' outside while I was watching Knight Rider and reruns of Gomer Pyle... that was the lyrics to the theme song for The Facts of Life. Sadly, I didn't even have to Google that.

Anyhow, we (as the title suggests) got some good news and bad today. Good for my wife as she was approved through her insurance pretty much full stop. She just has to provide some records and a letter of necessity from her doctor. Done deal.

Me, on the other hand, come bearing a sadder tale. Unfortunately, my insurance outright denied the request. Actually, it wasn't so much the insurance company as the company I work for that designated our policy to not include any and all bariatric-related work. WTF? Out of respect for my employer, I'll keep my comments to myself regarding this topic alone... for now.

Anyhow, I'm hit with a few options here. 1) I move over to my wife's insurance which wouldn't happen until January - 8 months from now and hope they cover me then or 2) self pay.

Obviously, utilizing the insurance would be the most cost effective route. However, there will be about 6 months where I will be holding 2 insurance coverages since my current one I won't be able to cancel until June. So, the question is whether my wife's insurance will even cover me if they see my primary is still active. If not, I will have to wait until June (one year from now) for that to lapse. Then I would be back to square one where I need to re-apply with the new insurance. Given that, I'm worried then about the carrier saying, "Hey now... you just got on and you're already asking for a $25,000 surgery? What's up with that? Is this the reason you jumped over to our service in the first place?" I know how these insurance people can be. Of course, they're job is to get out of paying as much as they can and I don't put this past them. Pardon me for being cynical in this regard. Nevertheless, at this point I could potentially be back to square one again a year and a half later.

So, I'm now at the point where I'm thinking it's worth $500/month to just get it done and not deal with all of that nonsense. But I'm just one of those 'get it done now and get it done right' kind of guys. Trust me, the monthly payment will be no easy task. But I'm at the point now where I feel money is something that comes and goes - my life is not.

Thoughts? Do I hold out for the insurance or go for it?

1 comment:

Jamie said...

Oh!.... I am sorry to hear that your company would put restrictions like that on their insurance policys. They suck!!

I hope you are able to work something out. $500 a month is alot. But I understand the 'get it done now' feeling. Ever since I made the (huge)decision to move forward with WLS everything is taking for.ev.er.!!

I am happy for your wife that she is able to move forward. Good luck to her!!