Seeking Advice on Reversal Surgery and Insurance Challenges

I've had mine for 2 years now and it was only meant to be temporary. Due to me having to go home (South Africa) where there was no chance of me getting it done, I have returned to the USA. I was told by my surgeon to lose 50 lb before he would consider doing the operation. I can proudly say I'm now down 75 lbs, but the end is no closer. I was operated on in an emergency situation, and due to my immigration status in NY and the team at Northwell, I was able to avoid massive medical bills, and I thank all my luckiest of stars about that. The problem now is that the reversal surgery is seen as a pre-existing condition, and my insurance won't touch it. Is anyone in the same boat? I really would love to get back to a normal life but remain positive.

Why can't you get it done in South Africa?

IGGIE

Where are you getting your insurance? A policy from an employer should cover pre-existing conditions. I don't know if this is required or not, but I've never had a job where it didn't.

And I second IGGIE's question: why not in South Africa? They have modern medical facilities and skilled doctors.

He said his immigration status saved him big bucks being here on medical bills.

True that?

Whoa! Seriously?

US taxpayers paid that bill.

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G-Day Susan,

Probably because he would have to pay for it.

IGGIE

Emergency surgery

Hi everyone

Just wanted to explain some things from the questions asked above

First of all, thank you for your interest in my story. I just wanted to tell it as this is a space of like-minded people with the daily challenges I have.

1. Yes, the taxpayers did help me out with my bills, but I'm a full taxpayer myself and didn't ask for help. The hospital admin recommended this path as we didn't have over 250k for the operation, and our insurance we receive from our employer did not cover everything. They assisted us in making that an option. Yes, I'm an immigrant but am fully legal and have been waiting for 3 years for my employment-based green card. I have been working and paying taxes since 2016. I find that comment a little insensitive. I did not come to this country to abuse the taxpayers or the medical system. I pay my way, work hard, and try to be the best person I can be to everyone around me. This just happened to me out of nowhere, and thankfully I was in this amazing country with amazing doctors that could save my life and fix the problem I had.
2. In South Africa, there was a 4-year wait list for the surgery. Back home, I was only there for a few months in order to renew my visa and therefore could not get it done.
3. I never expect handouts; I just wrote this hoping to hear from people with similar stories, that's all.

I'm sorry if I seemed insensitive. Your explanations make perfect sense. And it is not your fault that you had an emergency. I'm appalled that the waiting list in South Africa is so long. I have a lot of work colleagues based in South Africa, and I had no idea.

I just thought that employer policies covered pre-existing conditions. Check the provisions carefully because there may be a waiting period for coverage of pre-existing conditions. I saw that in the past, and perhaps your policy is like that. Do not trust the insurance company to tell you; look at the contract yourself. Your HR may be able to help you. Insurance companies will do anything to avoid paying. But you and your employer are paying them to cover necessary medical bills, so they need to hold up their end of the bargain.

If there's truly no coverage even after a waiting period, consider getting a policy through the Affordable Care Act. You may have to wait for open enrollment next fall, but verify my assumption. I don't actually remember.

G-Day David,

Information from you is accepted, and I give you my apology.

Regards, IGGIE

I've had emergency surgery... and paid every cent of the bill.

You can't fault someone for taking the advice of the hospital finance department. It isn't like he sought out this solution for himself. Considering he had insurance, it sounds like he was trying to be responsible.

Did you really pay every penny without insurance picking up any of it? If so, I'm impressed. I couldn't do that.

Is this what this site is about, berating others because of how they managed their medical bills? I thought we were about supporting each other through these difficult, complex, and very personal medical issues.

Good point, that's why I apologized after.

IGGIE