HELP with Anthem Insurance Company

[DianaCox]

AND in my spare time, I cooked an amazing angus beef tri-tip on the rotisserie (from Costco - wonderful marinade on it!) and I had marinated (http://www.mccormick.com/Lawrys/Flavors/Marinades/Cajun-Marinade-with-Zatarains-Seasoning) a mess of chicken thighs a couple of days ago that I cooked too, for snacks. Didn't taste the chicken but the tri-tip fantastic - I'm guessing my ravenous boarders probably ate most of it - I didn't look.

We go to the surgeon tomorrow for Charles' preop appointment - I think he developed a second inguinal hernia in the last month. We are going camping this weekend in Pismo (stalkers: we have people staying at the house), and his surgery will be on the 23rd, if we get the insurance authorization for the whole thing (including the inguinal hernia(s), umbilical hernias and diastasis repair - which is going to be the sticking point, as diastasis repair is usually considered cosmetic, EXCEPT when there is also an umbilical hernia (so he doesn't have to have mesh) - we'll see whether I'll be fighting yet ANOTHER insurance battle over that!

 

[more2adore]

I didn't know where to add this little tidbit since I don't think it deserves its own thread, but I won another insurance battle today - this time after several weeks of fighting with our current (Australian) insurance policy to get them to cover pre-existing conditions for me already (they were saying there was a 12-month wait). They finally agreed today that, yes, I had excellent cover previously and I have NOT been without insurance for several years, so I shouldn't be subject to a waiting period. FINALLY. So now they'll cover my stay in a private hospital here and the most it will cost me is $490 (deductible).

The surgeon's & anesthetist's fees are not included though (that's just how private insurance works here) so it will cost us about $5k, if I'm understanding the system here correctly. The surgeon's office will confirm Friday. It won't be covered by Medicare (it only would be if I were having my surgery via the public system at a public hospital... my surgeon will do surgeries via the public system, but it would be a year wait, and he's very selective about who is badly off enough financially that they need those spaces, understandably, and as hard as we have it at the moment on one income there are surely others worse off. Also, you can tend to get flak from hospital staff for using public resources when you're from another state, and I'd probably get it even worse since I'm a new immigrant.

I know there are people who would LOVE to just have to pay $5k for this surgery from a vetted surgeon, so I am definitely counting my lucky stars!