I can never get ahead…

Well my post for today was very different until I found out some upsetting information.

 

I got my approval letter in the mail for financial assistance through the hospital. I didn’t really understand everything it was saying, so I called today to have it explained to me. My friend I work with, Meaghan, was able to get assistance with the cost of the surgery and only had to pay about $225 for it. Since our insurance states that we must pay 20% (up to $3000) of the surgery cost, I was very excited about this and it was basically why I decided to have the surgery, otherwise couldn’t afford it.

 

So today I called to find out more about it, and what I would be covered for. I found out that 1. The coverage changed from last year, and it isn’t as good. 2. Everything is based on your income and family size 3. This is basically like applying for additional insurance.

 

The letter I got had a breakdown of what my deductible or % would be through that specific hospital based on what I made. Because I make less than Meaghan, we thought the covered would be better. What we didn’t think of is that she has a child, thus making her family size 2, not 1 like me.

 

This is a photo of that breakdown-

 

 

If you look down by the bottom, it says “Inpatient Admission” and next to it, it says $8800. That’s MY portion of my surgery. So if my insurance was worse than that, I’d only have to pay $8800. It isn’t, so basically this is NO help to me what-so-ever.

 

The woman I spoke with told me that last year, they only had 3 tiers, and even if I qualified for tier 3, I’d only have to pay $450, but because of all the changes, this probably wouldn’t help me very much if I have my own insurance. Now they have 6 tiers, 6 being the worst coverage, and 1 being the best. I’m tier 5. I don’t even want to know what tier 6 is.

 

So I called my insurance company and found out what I have to pay. My insurance has a $500 deductible, and then I have to pay 20%, up to an aggregate total of $3000. So all of my oop expenses that I have will add up throughout the year (co-pays, and such) and once I hit 3000, I don’t have to pay anymore. I have already paid $660.00, so I’ll probably owe the hospital another $2800.

 

Basically the entire reason why I thought I could do this surgery and why I started is because I thought I would have help. I honestly and truly cannot afford to have ANOTHER debt hanging over my head. I am so frustrated. Nate and I were finally getting on track with all of our finances, things were really looking up. We consolidated our debt and were working to pay it off so we can buy some land next year and start building our house. Our rent has increased and everything is becoming too expensive, and that is why we wanted to start building our house so we had less money going out. But in order to build our house, we have to pay down our debt and save some money for a down payment. It’s like a vicious cycle.

 

I feel so defeated. We have this huge debt to pay and it’s too late for me to back out. The only thing that made me feel better is when I talked to Nate. He told me we have come too far, and have gone though 8 months of frustration and agony to back out now. Plus, there is a reason I am doing it and money shouldn’t hinder that. I really do love him a lot, without him I think I would have had a major break down. He is so supportive and I am so thankful for him.

 

I just need to continue to be positive and remember why I am doing this.

August 6th, 2014

After all my bitching, complaining, frustrations, hard work, dieting, and phone calls, I FINALLY have gotten my surgery date and have been APPROVED!! This last process has taken almost a MONTH just to get my approval date. I had my last appointment on April 14th, where I got my final approval. It took them almost a month to fax paperwork.

There are a lot of emotions going through my head right now- the first one is disappointment. I know I know- I’ve been waiting for this since January, I should be excited! But I am disappointed because it’s not earlier, and it could have been if my paperwork was faxed in a timely manner. I wanted it earlier in the summer so I could heal before a lot of other things that are coming up in the fall, and I wanted to be able to start hiking and doing more active things this summer. But- I will be losing a bit more weight before the surgery, so being active this summer will help do that. So I will try to stay positive.

I am VERY excited too- because I have waited for this for a while, and I can’t believe it is really happening. I DO feel like a huge weight has been lifted and like I can finally relax and get my stuff together. I have exactly 3 months to get everything I need, organize my life, and prepare. But I’m also really nervous. About the surgery itself, the pain, the life changing experience. As soon as I found out my date, I instantly got butterflies in my stomach and was nervous. I really don’t know how I’ll be once they are actually prepping me for surgery. I’ll probably need to be tranq’d.


In other news:
Tuesday, one of my best friends, Kelly, had her Gastric Bypass. I went to visit her at the hospital that day to see how she was, and to spend some time with her. She was just glowing, it’s the only way I can really describe her. She was so happy and excited, like she knew only good things were going to happen from that point forward. She said to me, “I feel so great! I woke up, and I said ‘Wow, it really happened. No one can deny me, no one can take it away. It actually happened. I did it.”

A few days later, she is in a bit of pain, and she gets to go home today, but I know her thoughts haven’t changed. She still feels great despite the pain, her doctor and nurses said how amazing she is doing, and I am so happy and proud for her. I PRAY that I do HALF as well as she has done.

I feel so lucky to have these amazing woman in my life who have been able to experience this before me, so I can learn from them and they can guide me into the next stage of life. Not many people going through this process can say that not only do that have an amazing support system, but they have multiple people who have had the surgery and can share their experiences. And even though this has been a long process, and continues to be a long process, I am very thankful that I am even able to do this. I hope the next three months will go quickly!

Update

Well there really isn’t an update, because nothing new has happened. My surgeons office SAID they sent the paperwork to the insurance company, but yet my insurance company hasn’t gotten it yet.

I’m about to scream.

I have a control issue. Anyone who knows me knows this; I like having control, I like being the boss, I want to just do it myself. And not being in control of this situation has cause me a lot of stress and anger that I just do not know how to deal with. How hard is it to fax paperwork??

I have to get all of my time off approved, but I need my date to do that. My mom needs to buy her plane tickets, but I need my date to do that. I need to know when I am going to be out of work, but AGAIN I need my date to do that. This entire this is centered around ONE MAN faxing my paperwork to my insurance company. I could do his job better if I went there TODAY to do it.

Trying to plan all of this has put some un-welcome thoughts into my brain. I have been thinking a lot about after the surgery and what my life is going to be like. One of the thoughts is- do I really want to do this? I know I went through this in the beginning and I have 500 pro’s and con’s lists to show my thought process. I just keep thinking, how long will it take for my life to go back to normal? Will I lose too much weight? Will I not lose enough? What if I have complications and this never works for me? These questions keep me up at night.

I haven’t really had any negative responses to my surgery, and I have been telling everyone. But I find that I’m asking myself the questions I dreaded being asked. Could I do this on my own? Is this really going to be worth it?

People who have had the surgery tell me it is worth it. But because I haven’t experienced it myself, I don’t know for sure.

I worry about my relationships. Will they look at me differently because I am smaller? Will some be jealous? Will they think I’m acting different? Will I act different? All I have had is this tight-knit support system, but what happens when that falls apart? Stories from other people’s experiences are creeping into my subconscious and it is making me freak out. I guess I just need to trust in my relationships and hope for the best.

I am sure all of you hate me asking these questions, maybe one day I’ll be able to answer them though. That’s the beauty of having this blog, I am able to look back and remember my struggle and my questions, and re-evaluate myself. I feel that self-reflection is what is going to give me strength through this whole process.

You can’t expect everything else to change if you don’t change yourself, and that means outside and in.

So I will just take a deep breath and call my surgeons office again until they send the paperwork.