boy did i get kicked in the stomach

[sara]

the insurance person in her office may be able to answer your questions about insurance. If not, you will need to get a copy of your EOC (evidence of coverage - a lengthy document, not a summary) and sort it out yourself. @DianaCox and I can help with that if needed - and she's better at it than I am. But that's where you start.

ill call tomorrow. thanks for your help. MY fiancé is c/o the drive to carmel and check ups. What do you mean by pcps

 

[Larra]

primary care provider - your regular doctor.

 

[Settledownnow]

Dr. Kemmeter in Michigan does a revision to DS.

Still, gaining 50 pounds in one month sounds almost impossible. You do need to follow up with your doc and the endocrinologist to see if something else is going on before you look at more surgery.

 

[Jo777]

Ditto on getting everything checked out- 50lbs (of fat gain) in a month is near-impossible.. edema, that would point to some pretty nasty things happening.. even 50lbs over a couple months time would seriously be pushing it. The other hoops.. well, not completely horrible- but considering they weren't a factor before you expressed a desire for the DS.. would give me second thoughts on the surgeon.

 

[Munchkin]

The switch is the next logical step for anyone with a sleeve! The OP is half done already. Revision to RNY makes no sense at all.

50lbs in a month? I agree you need to get that checked out!

 

[GirlFriday]

ill call tomorrow. thanks for your help. MY fiancé is c/o the drive to carmel and check ups. What do you mean by pcps

Dr. Inman did my surgery. You need to go to mybrandnewlife.org and look up her information. Coral in Dr. Inman's office has one job and that is to beat the insurance companies into submission. My mother is having the surgery done and Medicare and Humana are paying for it...she had no problem getting approval, but you need to talk to Coral and she will get you taken care of. Also, Kami and Karen are the physician assistant and nurse practioner Inman's office...they will work with your regular doctor to make sure that you get the follow-up from him or her.

I have a friend from Illinois that went to Inman for her DS and she does all of her follow-ups with her PCP and has only been back to Carmel once in the four months since her surgery.

 

[southernlady]

its the sleeve thank you for your feedback how do I get medicare to approve out of state

Medicare will let you go to ANY doctor regardless of state as long as that doctor accepts Medicare. Exception is BCBS Medicare Advantage, they do not want you crossing state lines IF there is someone in state to do the surgery.

Medicare is a federal program and the card is blue and red on a white background. (looks like this)

However if it's Medicaid NOT Medicare, you will have a MUCH harder time crossing state lines. Medicaid is STATE based and extremely hard to get accepted anywhere other than your own state.

Exactly what policy do you have? I have a Medicare Advantage policy.

 

[Spiky Bugger]

Medicare will let you go to ANY doctor regardless of state as long as that doctor accepts Medicare. Exception is BCBS Medicare Advantage, they do not want you crossing state lines IF there is someone in state to do the surgery.

Medicare is a federal program and the card is blue and red on a white background. (looks like this)

However if it's Medicaid NOT Medicare, you will have a MUCH harder time crossing state lines. Medicaid is STATE based and extremely hard to get accepted anywhere other than your own state.

Exactly what policy do you have? I have a Medicare Advantage policy.

That was one of the things I was going to say...and to the best of my knowledge, Medicare (REAL Medicare...not an HMO that is Medicare based...like an Advantage plan...because an HMO is an HMO) doesn't preauthorize.

And if you need a real Medicare plan, you CAN change at open enrollment...and change back the next year.

Also...being a snob is a good thing to learn. We don't look for who is closest that insurance might pay for. We look for THE BEST and figure out how to make insurance pay for it.

Sue

 

[southernlady]

And if you need a real Medicare plan, you CAN change at open enrollment...and change back the next year.

And Medicare Open enrollment starts the 15th of Oct and ENDS Dec 7th.