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Member
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Join Date: Sep 2006
Posts: 292
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Member
Join Date: Sep 2006
Posts: 292
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What a mess & surgery ??
Hi everyone,
I know I haven't been around much lately. Lots of excuses but they are all boring. No one really cares how many hours I sleep each day or how slowly I move when I can move. Plus my voice has gotten very hoarse so Dragon is not doing as good of a job as it was.
Anyway, I am scheduled to have the intrathecal morphine pump put in tomorrow morning at 7 am.
I got an authorization letter from my insurance.
Today, my doctor's office called and said that I am no longer eligible with my Private insurance company!   We had just paid the May thru October premiums. They said Cobra was only 3 years, I'm not on Cobra and it's been 5 years. Then, they said, well, disabiity is only covered for 5 years. But I said it has been 5 years and 3 months and I am on work comp, not short term disability.
Worker's comp denied the surgery & my lawyer wouldn't go to court to do an expedited appeal for me, SO my Private Insurance sent me a letter of approval with a disclaimer that I must be elibible at the time of surgery.
Suddenly they made me ineligible right after that authorization letter & surgery was scheduled without ever letting me know and my surgery is tomorrow !!
Well, suddenly after approval for this $100,000. ++ procedure I am no longer eligible  .
Does that make sense? I wasn't on Cobra, that is why my insurance lasted over 5 years and NOT at Cobra rates ($350./month), it was $64/month because I am an employee of the insurance company. So then a supervisor tells me I am on disability and that ends in 5 years...still this is 5 years and 3 months, not 5 years.
Up until I got the OK to cover my surgery I was covered.
Human Resources said in a week they'll send out a cobra package and retro me back to June 1 and I'll be covered.
Also I can go on my husbands insurance July 1st. They don't have any pre-existing clause.
So I told the doctors office to cancel it. They had checked with Medicare and my cost would be $992. deductible and 80% coverage. But they don't cover the $3000. worth of medications I'll need every month, since I don't have medicare Part D for medicines.
I hope you can all follow this mess.
Right now it looks like I'll have this done under medicare and hope Cobra comes through for me.
What a thing to have to deal with the day before surgery.
I'm not sure what will happen with this nightmare. It never stops, it is one thing after another. I understand more and more how people who have RSD (&TOS) can commit suicide (not that I'd think of it). But it sure would end this nightmare .
My lawyer never goes to court for me and I can't change lawyers since this is my second onei. I have $100,000's of dollars on liens. Unpaid pharmacies, doctors, outpatient surgicenters, botox injections, MRI's. I can't get ANY care for my TOS even though surgery is put into my doctors list of future medical needs. Thanks for letting me vent. I really needed to do that.
((hugs)) Hope 
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