Thoracic Outlet Syndrome Thoracic Outlet Syndrome/Brachial Plexopathy. In Memory Of DeAnne Marie.


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Old 06-04-2007, 01:37 PM #1
HopeLivesHere HopeLivesHere is offline
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Join Date: Sep 2006
Posts: 292
15 yr Member
HopeLivesHere HopeLivesHere is offline
Member
 
Join Date: Sep 2006
Posts: 292
15 yr Member
Unhappy What a mess & surgery ??

Hi
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.
My doctor's office just called and said that I am no longer eligible with my Private insurance company!
We had just paid the May thru October premiums.

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.

Well, suddenly after approval for this $100,000. ++ procedure I am no longer eligible. I was injured and out of work 5 years and 3 months ago and they said my Cobra ended after 3 years, even though they continued to cover me an additional 3 yrs +.
Now 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. Like I trust them on that.

Also I can't go on my husbands insurance until July 1st IF they will even cover me. They don't have any pre-existing clause, and I won't know anything today.
Still if I go on my husband's insurance, I will need preauthorization for the surgery and there is no time for that.
So I told the doctors office to cancel it. They had checked with Medicare and my cost would be $992. deductible and 80% coverage. And I don't know if they'll 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.
My husband is going to HR to try to get me on his insurance retro to June 1 because I've had services .
I think of Olecyn when I see what a mess I'm in....sorry Cyndy, but I know you pay out of pocket for medical care too. I'm not sure what will happen but I'll keep you updated throught the day, if you'd like to hear this nightmare. It never stops, it is one night mare after another. I understand more and more how people who have RSD and TOS can commit suicide (not that I'd think of it). But it sure would end this nightmare.
Work COmp hasn't paid a thing on me for 5 years this Sept. My lawyer never goes to court for me. 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

Last edited by HopeLivesHere; 06-04-2007 at 08:03 PM.
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