Tag: medical insurance

Make It Personal

Make It Personal

Amputation is a tough road. If you make the decision to amputate or if your limb is taken from you by accident or disease it’s a bumpy ride, right from the get go.

Most people assume that once you get through the surgical part and physically heal that you are back to life as usual. that couldn’t be farther from the truth.

As an amputee with 6 1/2 years of experience I can tell you that once I healed and was able to get fitted with a prothesis my journey of ups and downs was just beginning.

The one aspect that I am extremely grateful to my GP for pointing out to me was insurance. Even though I had my head wrapped around the idea of taking my leg, and I knew I had the grit and determination to tolerate all the limb changes that were coming, I needed to be sure that A) I knew what type of prosthesis I needed to live an active life and B) that my insurance covered it.

What I fought for:

 

 

 

 

 

 

This was the beginning of the most emotional and draining 4 weeks of my life. This was a fight I wasn’t prepared for, even though I thought I was.

This week I take you through what I did to cover myself, (or at least thought that I was covered), what happened that spun me out of control for 4 weeks, and how I bounced back to fight for the leg I needed to live a good and healthy life.

You may have to deal with this for yourself or someone you love, it’s good information, and from someone who now has to fight every 3 years to get the leg she needs to be mobile and I hope that my story helps you in your fight.

“No”should never be the answer when someone wants to be as mobile and healthy as they can be. We must learn how to prepare to face the insurance giants and how they work so we can be ready to stand up for ourselves and the lives we want to lead.

It’s no easy task but it is one worth our time and energy.

Remember the old saying, “The squeaky wheel gets the oil?” That became my motto that entire month I fought for my prosthesis.

Are you facing this blockade in your future, or even right now?

Check out how I went to battle and what you can do to prepare yourself.

 

 

Let’s get prepared!

First, understand your insurance plan. Look for what is covered under external prosthesis devices and what is needed to be approved, usually notation from doctor of it being “medically necessary”.

Second, get with your prosthetist and find out exactly what type of prosthesis you’ll be getting according to what your lifestyle was, what you dream of doing, and what you will be capable of (Usually you’ll take a K level test to determine your ability-my PT did this with me).

Third, get the code(s) that can be tricky and denied by most insurances and start making the call to your insurance company and ask if it’s covered by your insurance.

I even went to the extreme of calling my insurance company multiple times over the 4 months before my surgery to hear different employees tell me that “Yes, that code is covered.” Now they had it on recorded phone calls (Important to know that all calls are recorded, however, if you ask for the recordings they will tell you that your lawyer will have to file for them!!! Yes, I asked because I thought I was going to have to sue them for undo stress!).

This should be a great start to getting your approval, but even though I did all of these things, I actually got a big ‘ole “NO!” after my amputation… and while I had done my due diligence I hadn’t planned on my insurance company changing the wording on my plan after the first of the year to NOT include the code that was previously approved.

These are the unknowns you can’t prepare for but must find it in yourself to fight beyond that. You need to connect with people that can help, your doctor, your prosthetist, the prosthetic company even has their own insurance coordinator, and MAKE IT PERSONAL!

I made sure the calls I made to supervisors every day that month that I told them who I was, about my family, and my hopes and dreams I had for my future. You are NOT a claim number you are a person with a life. Make them see that and feel that.

 

These are just some starting points but I hope they help you navigate the crazy world of insurance claims.

Now get up and fight for your life of your dreams!

Don’t take No for an answer, dear Warriors!

Rise up and fight!!

Have a beautiful day and as always,

Be Healthy,

Be Happy,

Be YOU!!!

 

Much love,

 

 

Insurance Games

Insurance Games

Playing To Win; Playing For Your Future

 

Dealing with insurance can be tricky and often frustrating. I speak from experience.

It’s unfortunate that insurance companies make it so hard to understand the ins and outs of their policies as well as getting approvals especially since those who are trying to get covered are often going through really tough emotional times.

As I got myself prepared for my amputation I was doing everything to prepare myself, mentally, emotionally, physically, and financially seeing as this would be a forever life changing surgery.

My experience was not smooth, nor was it kind, but I figured out how to handle my situation, found my voice, and fought for what was right and what I needed.

Join me this week as I take you on my journey with the games that insurance companies play, and how you can play and beat them at their own game.

 

This is what I fought to get……

 

So I can do this….

 

…And this

 

….And this

 

…And this.

 

 

 

 

 

 

What are you fighting for? And if you’re not fighting for what you want, then who will???

 

Randy and David at The Limb Center and also Limbs For Humanity

 

 

This week, if you are in the middle of a big decision that takes medical insurance, make sure you do your homework and get confirmation about what is covered.

If you have been told “No” by your insurance company then it’s time to fight for what you want and need.

We must fight for ourselves, because only we know exactly what we need and want to make our lives worth living.

Help yourself by fighting for your future. Don’t give up, and don’t take “No” for an answer!

You are a warrior and you are WORTH IT!!

 

Have a blessed week and as always,

Be Healthy,

Be Happy,

Be YOU!!!

 

Much love,

 

 

You’ve Got to Fight for Your Right….

You’ve Got to Fight for Your Right….

To Party.. I mean, for Medical Insurance

Sorry, I had the Beastie Boys song stuck in my head. But, for real, do what they say and FIGHT for your rights!!!! They know what’s up!

 

The Beastie Boys had it right when they sang, “You’ve got to fight, for your right to party” however I’d say you should also fight for your right to having appropriate medical coverage, and for us amputees, the right to mobility.
As if becoming an amputee is an easy adjustment, mentally, emotionally or physically, we should not have to struggle with the draining process of being initially denied prosthetics and fighting another battle.
Come along with me in this podcast to hear some tips I’ve learned along the way of my own insurance fiasco, denials and all.
Find out what the best piece of advice I was given by my GP prior to my decision to amputate, how I surrounded myself with the right medical team, what I did to “assure” that my insurance plan covered my specific prosthesis and what I did when it all fell apart.
Somewhere along my personal journey I hope you find the tools to help yourself when the time comes to fight for your own medical coverage and how to handle things when they get denied.
Don’t give up!
Never surrender!
Be the squeaky wheel and fight for the life you deserve to live.
Fight!!! Me BEFORE my injury which led to my subsequent amputation
If you know you will need to rely on your medical insurance in the near future, like I did with an amputation, do your research, ask questions, ask more questions. Be prepared!
Don’t take no for an answer-insurance companies always say no first and expect that a majority of people will just quietly go away.
Don’t give up. Ask for help, if you need to, but be proactive, persistent, and strong… for your own health and happiness in the future.
As always,
Be Healthy,
Be Happy,
Be YOU!!!
Much love,
Angie