Ins approval-rescended a NEW way-Please Read

[LBP]

I was in a panic too when my COBRA was about to expire. I exhausted my Federal COBRA and then my State extended COBRA....but it was all over, I qualified for a state program. In Wisconsin it's called HIRSP. Under this program I qualified for insurance with no exceptions for preconditions because I had exhausted my Cobra and had applied for this new insurance immediately. Please look into your own state health programs. You might be able to find something. There are a variety of things here but some are based on income, whether you have a family or a single etc.


In any case PLEASE send your story to Harrison at info@adrsupport.org so he can forward it to Oprah!

[D. Coley]

LBP,
Thanks for the information. I am trying to find out about the extension now. I didn't finish this post before they said OKlahoma does NOT offer anything except Medicare or SoonerCare. Just great

I have already sent my stuff to Harrison and actually he called me yesterday to discuss a few things directly. I hope everyone else sends theirs because this is a great opportunity for everyone suffering!!

I spoke to the Charite group this morning and referred them to this site and referred to the submission that Harrison is putting together. Bill Milligan is the rep that I have been dealing with there and has promptly done everything he can for my case.

Oh by the way, I talked to Dr. Smith's office this morning and the x-stop procedures for stenosis were fantasically sucessful that they performed but ins co's cut the coverage for them in 2006. Their motto is "Lets not fix anyone!! Lets just take their money until their DEAD!!"

[ZorroSF]

it really sounds like you need some more advice from doctors before you go back to blue shield to refute their dismissiveness. don't do the many operation routine. I'm in deep *$#@ as it is, and wish I had done much more testing pre-op. I probably should've had a fusion and ADR. Instead I am probably heading for more surgery as it stands.

[LBP]

D Coley,

I went to the OK Dept of Ins and found the following link...http://www.okhrp.com/


This is comparable to what I have in WI. You might want to call them to see if you automatically qualify because your Cobra as been exhausted. (have you exhausted a state extended cobra beyond the federal cobra benefits?) You should receive a notice from your insurance company giving you this option with a very short and firm deadline to respond. I don't know if all states offer state extended cobra benefits.)

[D. Coley]

I talked to the OK Insurance Dept earlier today. That program is called the Oklahoma High Risk Pool and is for persons that can't get coverage through a private carrier, very high premiums!! There is not any extension of COBRA at the state level for Oklahoma. I got that confirmed from the US Dept of Laber earlier today also.

[LBP]

Sadly, their high premiums may be less than quotes you get, if approved with other plans. I am not working so I was able to get a premium reduction based on income for my high risk plan, plus the premiums were much more than my prior COBRA premiums.

Does Aetna offer individual plans in OK? They don't in WI, otherwise I would prob have been willing to pay a higher premium knowing I could get my surgery!

[ZorroSF]

well after reading most of this book;

http://adrsupport.org/eve/forums/a/t...1/m/8571067452


it alludes to most expensive surgeries being recinded after authorization. In most cases if they do approve the surgery, they turn around and then state they will only pay for $1500. This doesn't matter if you have a spine surgery or cancer surgery. The author tell you how the process works.

I can tell you it ain't pretty. In fact I am so pissed after reading this book I just want to contact the attorney general's office to report this criminal behavior.

[LBP]

Coley,

PLEASEEEEEEEEEEEEEEEEEEE send your story to harrison so it can be included in the first thread of the "big file"

Your insurance experience is HORRIBLE and needs to be heard

[D. Coley]

LBP, thanks for your concern. I already submitted my story to Harrison on Sunday 6/10. He called me directly to discuss several details and said I was one of the first few responses that he received. I called the surgeons office today and am getting the AxiaLIF procedure authorized by the insurance co and getting a surgery date scheduled ASAP. I have waited as long as I can...

[D. Coley]

Zorro, by the way... Dr. Smith is my third opinion to determine if surgery is appropriate.

I went to a woman neurosurgeon in the early fall of 2006 til the end of the year..she's the one that put me through all the physical therapy, pills (most of which I wouldn't take which pissed her off), injections and discogram. She would NOT do the disc replacement on me (not trained to do it-so I found out) and kept pushing me toward the traditional anterior lumbar fusion. I kept telling her that a regular fusion was NOT what I wanted and she wouldn't listen!!!!

The second opinion surgeon (Dr. Kelley) said "it's not bad at all..not even to justify taking pain pills and he would NOT operate on me". He was a snot nosed young rich kid that probably has never had any pain in his life and this is his first job. I thought my husband was going to whip him right there in the exam room.

Dr. Smith backs the first surgeon that ONLY surgery will fix it! Dr. Smith said that the discogram was totally unnessary because it is very clear from the MRI alone that the disc is TOAST at L5-S1!!!!

Funny part is that Dr Smith and Dr Kelley are in the same neorosurgery group and Dr. Smith is the chief honcho so I know there were some angry words spoken bewteen them when Dr. Smith found out what Dr. Kelley had said to me!! Ha HA Sure made me feel better..