Author Topic: insurance help.... questions  (Read 2652 times)

Offline tttdone

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hi. i go to kaiser and i saw my endo a couple days ago and he said THE OLD 4 requirements for the surgery to be covered are:
1. the gyno hasnt grown in size in the last year
2. the patient is non-obese (if they are obese they have to loose the weight first)
3.the patient is under 19 years old
4. no marijuana / drug use

he said since medicare didnt accept these conditions, so kaiser cant use them, so now there are TECHINICALLY no requirements... it is just up to the surgeon if insureance will cover it.

i made the mistake of telling him that i have used marijuana in the past (before he told me these requirements).... so now i dont know what will happen. i go to see the surgeon in a coupld of weeks... i gusse my question is if the surgeion asks me if i have used marijuana should i say yes or no? did the endo put anything in my record about it? i know that the four requirments above technically arent valid but i dont know if the surgeons still use them to decide whethere to do the surgery or not....
-i meet all of the other requirments... and my gyne started WAY before i ever used marijuana..but i dont know if that will matter or not.

thanks
Surgery on 8/20/2008

Offline MSJ108

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I heard if the gyno is "causing pain and discomfort" you may have a chance to get insurance to cover some of it.

Offline moobius

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I heard if the gyno is "causing pain and discomfort" you may have a chance to get insurance to cover some of it.

doubtful... the doc that works for the insurance companies will deam it unecessary/cosmetic. (that's what they pay him to do...)

Offline MSJ108

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well if you have pain and discomfort its worth a shot!  :)


 

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