insurance

January 30, 2004

In a message dated 1/30/04 9:12:37 AM Eastern Standard Time,

ae_mcd2003@... writes:

http://www.boston.com/news/nation/articles/2004/01/30/rejecting_health_insurer

s/

Ann,

I read the article. While it is " right on " in most cases, I do think it

misrepresented the consierge system. My PCP has changed over to this and my

husband and I decided to stay with him. That is partly because of my complex

medical problems, and our long association with him. However, he does not have

a

fancy office. He did curtail his practice a bit, because the insurance

companies were requiring him to just push people through as fast as he could.

He is

a very caring man. Even before he changed, he was available to us by email.

Maybe he is an exception. However, I just wanted to make it clear that he

does not get " a lot more money " now. He does, however, allow us to discuss more

than one problem in one visit, and always has. This is unlike my sister's doc

who tells her to make a new appointment if she brings up an aching ear when

she's there for her bursitis, etc.

I just don't want people to think that the concierge system is completely out

of touch with the patients.

Carole

I am not a doctor and have no medical knowledge to speak of. Also, I really

hope that I have not hurt anyone's feelings.

February 2, 2004

Hi Ann,

Did I enjoy the game? YES! Rah! Rah! Rah! My husband watched it very

quietly. I, on the other hand, was so excited that I was yelling! I wish I

could

be at the stadium for the welcome home, which is going on right now. However,

I would never survive in that crowd in the cold and standing for so long.

Watched that part on TV.

What a game!

By the way I understand your concerns about medical care delivery in general.

Honest. I do.

Carole

February 6, 2004

,

We have Federal Blue Cross/Blue Shield but because I went out of state I had

to deal with Blue Cross/Blue Shield of NC. I was denied before surgery so

after I put together an appeal and was ready to be turned down again but

instead I received $9,399.75. I'm not really sure what changed their minds

but they did. I'm in the process of appealing for more money because all

they considered was the hospital bill. I wish Dr. R would give us a

breakdown like the hospital does. I think it would help many of us get more

money from our insurance companies. I hope this helps.

By the way, I have not lost much in the past month or so but I did get into

a size 9 levi jeans. I had tried them on two or three weeks ago and had to

lay down on the bed to zip and button them but two days ago when I tried, I

zipped and buttoned them while standing. They are still alittle tight but

my mom said they looked good. They do push up and out the extra skin which

really is not very attractive. I'll wait alittle while longer before I wear

them in public.

Cami in IN

264/168

26-3x/9-medium

insurance

> Hello all,

> I need your help, please. I am sending a request to the Attorney General

of NC to see if they will require Blue Cross Blue Shield of NC to honor

their policies.

> I was denied reimbursement from BCBSNC based on their decision that the

MGB procedure is " experimental and investigational. " I found out that if

BCBS has paid anyone anywhere, they are obligated to pay all legitimate

claims for a given procedure. I need for everyone that has been reimbursed

for the surgery by ANY insurance company to please send me the name of the

company and the amount. That would help me tremendously, and maybe help

those who come after us to have the surgery without having to go through all

the mess we have had to in order to be reimbursed. If some of the insurance

companies are paying for the MGB it stands to reason that they have

accepted the MGB procedure as a valid surgery. Please, PLEASE take a few

minutes and e-mail with whatever info you have about reimbursements.

> I will deeply appreciate it. Thank you, Shew

>

> --------------------------------------------------------------------------

>

February 6, 2004

Hi ,

I have Aetna Managed Choice through my employer and while it took

over 11 months, Aetna finally paid a little over $11,000 of the

$17,000. I had to do a lot of work including getting Regional

to send me an itemized listing of all of the charges for the surgery

and hospital stay.

Aetna also listed the MGB as " investigational and experimental " , and

they initially denied my claim because I did not give proof of a

diet and exercise program prior to the surgery. I don't know if it

was a mistake or what, but once my physician wrote the necessary

letters regarding my diet and exercise history, Aetna approved the

claim. They never brought up the " investigational and experimental "

part during the claim and appeal process.

Good luck with your insurance company,

Elaine

1/3/03 250 pounds now 136 (size 6/8) WooHoo!!!

> Hello all,

> I need your help, please. I am sending a request to the Attorney

General of NC to see if they will require Blue Cross Blue Shield of

NC to honor their policies.

> I was denied reimbursement from BCBSNC based on their decision

that the MGB procedure is " experimental and investigational. " I

found out that if BCBS has paid anyone anywhere, they are obligated

to pay all legitimate claims for a given procedure. I need for

everyone that has been reimbursed for the surgery by ANY insurance

company to please send me the name of the company and the amount.

That would help me tremendously, and maybe help those who come after

us to have the surgery without having to go through all the mess we

have had to in order to be reimbursed. If some of the insurance

companies are paying for the MGB it stands to reason that they have

accepted the MGB procedure as a valid surgery. Please, PLEASE take a

few minutes and e-mail with whatever info you have about

reimbursements.

> I will deeply appreciate it. Thank you, Shew

>

> -------------------------------------------------------------------

-------

>

February 6, 2004

Carefirst Blue Cross Blue Shield of land - reimbursed 10,000 -

sen = appealing out of network restriction to get full reimbursement.

February 6, 2004

Speaking of insurance appeals; I am at the third appeal level in Aetna. The

say the operation is experimental yadda yadda. I would love to hear from

anyone who has received payment from Aetna. Also any advice as to how and what

to

present this time, that I haven't already said. Thanks, sueoyler@...

February 7, 2004

Thank you so very much for your response. I have received several and every

one will help. Bless you!

insurance

>

> > Hello all,

> > I need your help, please. I am sending a request to the Attorney

General

> of NC to see if they will require Blue Cross Blue Shield of NC to honor

> their policies.

> > I was denied reimbursement from BCBSNC based on their decision that

the

> MGB procedure is " experimental and investigational. " I found out that if

> BCBS has paid anyone anywhere, they are obligated to pay all legitimate

> claims for a given procedure. I need for everyone that has been

reimbursed

> for the surgery by ANY insurance company to please send me the name of the

> company and the amount. That would help me tremendously, and maybe help

> those who come after us to have the surgery without having to go through

all

> the mess we have had to in order to be reimbursed. If some of the

insurance

> companies are paying for the MGB it stands to reason that they have

> accepted the MGB procedure as a valid surgery. Please, PLEASE take a few

> minutes and e-mail with whatever info you have about reimbursements.

> > I will deeply appreciate it. Thank you, Shew

> >

>

> --------------------------------------------------------------------------

> >

March 29, 2004

I belong to AARP but I don't have use their insurance. It's so great to hear

from you . It's been far too long since we did.

How are you?

Alice

March 29, 2004

Alice,

We are good. I live in a much nicer place now so am feeling lots

better and have the energy to pursue some things such as this

insurance thing which I hope to use for the 2nd CI.

Aside from the insurance, do you, and , think membership is

worth the annual fee? I'm going to drop in on a chapter meeting next

month and get a feel for the group.

*---* *---* *---* *---* *---*

Quoting one is plagiarism; quoting many is research.

& Gimlet (Guide Dawggie)

Portland, Oregon

N24C 3G 8/2000 Hookup

rlclark77@...

http://home.comcast.net/~rlclark77/

March 29, 2004

,

Yes, I think the AARP membership is definitely worth the fee.

:-)

~~~~~~~~~

----- Original Message -----

From:

Alice,

We are good. I live in a much nicer place now so am feeling lots

better and have the energy to pursue some things such as this

insurance thing which I hope to use for the 2nd CI.

Aside from the insurance, do you, and , think membership is

worth the annual fee? I'm going to drop in on a chapter meeting next

month and get a feel for the group.

March 29, 2004

I agree.

Alice

,

Yes, I think the AARP membership is definitely worth the fee.

:-)

March 29, 2004

Ok, well as much as I hate to admit I am gettin' older n sin

(hehehehehehehe) I may as well take advantage of what is offered us

oldies. There's a chapter meeting next week so will drop in.

*---* *---* *---* *---* *---*

We Would Be De-Lighted If You Sent In Your Bill.

However, If You Don't You Will Be.

--sign at the electric company

& Gimlet (Guide Dawggie)

Portland, Oregon

N24C 3G 8/2000 Hookup

rlclark77@...

http://home.comcast.net/~rlclark77/

June 26, 2004

In a message dated 6/26/04 4:15:57 PM Eastern Daylight Time,

psita@... writes:

> Does anyone know of an insurance company which will accept someone with

> hepatitis c? My husband only has three months before medicare, but I have 5

> years, and hippa is only $100,000.00 lifetime maximum. Thanks, Terry

>

I really know nothing about insurance - Mine is changing to Blue Cross soon,

but maybe this will help? --- <A

HREF= " http://www.hep-c-alert.org/links/hippa.html#prex " >http://www.hep-c-alert.o\

rg/links/hippa.html</A>

Best of luck,

Jane

June 26, 2004

In a message dated 6/26/04 4:15:57 PM Eastern Daylight Time,

psita@... writes:

> Does anyone know of an insurance company which will accept someone with

> hepatitis c? My husband only has three months before medicare, but I have 5

> years, and hippa is only $100,000.00 lifetime maximum. Thanks, Terry

>

I really know nothing about insurance - Mine is changing to Blue Cross soon,

but maybe this will help? --- <A

HREF= " http://www.hep-c-alert.org/links/hippa.html#prex " >http://www.hep-c-alert.o\

rg/links/hippa.html</A>

Best of luck,

Jane

June 26, 2004

Most insurance companies have a one year waiting period on pre-existing

conditions *if* you were insured at time of diagnosis. They tend to require a

statement from your insurance company at the time of diagnosis. I had a couple

different insurance companies after diagnosis...they all covered scripts right

away, but they all required a year waiting period before covering any procedures

associated with hcv.

Course now I live with no insurance...it always amazes me that there is no

health care program in this country.

insurance

Hello all,

We received a letter today stating that our group insurance policy will be

terminated July 31st. Does anyone know of an insurance company which will

accept someone with hepatitis c? My husband only has three months before

medicare, but I have 5 years, and hippa is only $100,000.00 lifetime maximum.

Thanks, Terry

June 26, 2004

Most insurance companies have a one year waiting period on pre-existing

conditions *if* you were insured at time of diagnosis. They tend to require a

statement from your insurance company at the time of diagnosis. I had a couple

different insurance companies after diagnosis...they all covered scripts right

away, but they all required a year waiting period before covering any procedures

associated with hcv.

Course now I live with no insurance...it always amazes me that there is no

health care program in this country.

insurance

Hello all,

We received a letter today stating that our group insurance policy will be

terminated July 31st. Does anyone know of an insurance company which will

accept someone with hepatitis c? My husband only has three months before

medicare, but I have 5 years, and hippa is only $100,000.00 lifetime maximum.

Thanks, Terry

June 27, 2004

Terry...

Can't help you then...I live without insurance and consider myself lucky to have

a job even if it doesn't offer insurance. My doctor of many years works with me

on the phone and I pop the big bucks to see him once a year. Anything else, I

deal with the County health system.

My belief is that as long as this administration is running the country, there

is no chance of getting any type of national health plan.

Tatezi

insurance

Tatezi,

I can't even get accepted, regardless of what they exclude for any period

of time. Blue Cross turned me down last year before we found this group

insurance, and now that is being terminated by United Health Care. Something

about the IUPIW, which is the group plan, underwritten by UHC, not meeting their

standards. I am not worried about the hepc right now. I have no extensive

damage, and am not about to treat again. It is all the other things that can

happen to a person, and the nearest free clinic is an hour away. I also do not

have the energy to do what you have done in the past to get treatment. It is

too exhausting and I will wind up in bed. We have our own doctors whom we like

and trust and do not want to change. What I need is an insurance company that

will except us with pre-existing conditions. I would gladly do the year without

being insured for hep c. Thanks, Terry

June 27, 2004