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  • Good News!

    [Good News!]

    Author: Karla (---.proxy.aol.com)

    Date: 10-14-02 07:54

    Hi All ,

    Just wanted to tell you that hubby has an appointment with Dr. Lever at CC scheduled for November 13th! He has received an itinerary of tests and packet of info from them - I am already impressed!

    We were fortunate to find air fare cheap from the "Land of the Mouse"!! I think he realized he wasn't up to driving.

    I have said it before, but I wanted to say it again..a BIG THANK you to Lisa, Sara-and ALL of you for the knowledge, guidance and support. If it wasn't for this web site, we would not have known which direction to turn!

    I will keep you posted!

    THANKS AGAIN!

    Karla

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    [Re: Good News!]

    Author: Lisa Salberg (---.dyn.optonline.net)

    Date: 10-14-02 09:06

    Karla -

    I am happy to hear you are on your way to quality care... and as always YOUR WELCOME!

    Lisa

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    [Re: Good News!]

    Author: Robert Hartwell (144.195.62.---)

    Date: 10-14-02 09:18

    Karla,

    If your impressed now, just wait till the 13th. My visit to Dr. Lever was on October 9 and I was more than impressed by him, the staff and CCF. I am convinced that there is no finer facility for the care and treatment of HOCM. Prepare for a long day but by the end of the day you and your Husband will know what to do.

    My Myectomy is scheduled for November 4th. Keep in touch with us on this board and let us know what happens. I am just a little ahead of you guys on this journey, if I can help in any way please let me know.

    Bob

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    [Re: Good News!]

    Author: Lisa Salberg (---.dyn.optonline.net)

    Date: 10-14-02 09:21

    Bob - Thanks for your input.... It is so nice to help and be helped along the way!

    Lisa

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    [Re: Good News!]

    Author: Karla (---.proxy.aol.com)

    Date: 10-15-02 07:34

    Bob - thank you for your two cents' worth concerning the care at CC... I have heard all kinds of good things about it, but it's always nice to hear from someone who has had a personal experience.

    Yes, from the itinerary they sent, it would appear that hubby is going to have a full day of testing/consults when he is there. It will be such a relief to finally have some answers! Hopefully, something can be done to improve his quality of life.

    I believe he is going none too soon, as his symptoms have continued and seem to have worsened since he was diagnosed 6 months ago. The beta-blocker that he has been taking does little or nothing at all in the way of relieving them.

    Six months has felt more like 6 years to me.....it's tough to watch someone you love, who used to be so active, get worn out over a simple task like washing a car. (sorry, venting a little here as a spouse!)

    k...'nuff of that pity party...

    Lisa - and everyone else - I will keep you posted!

    Karla

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    [Re: Good News!]

    Author: Matt (---.disney.com)

    Date: 10-15-02 09:10

    Karla,

    Are you going to be able to go with him? I hope so. It's always good to have a second set of ears (plus the support wouldn't hurt either).

    Matt

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    [Re: Good News!]

    Author: Karla (---.proxy.aol.com)

    Date: 10-17-02 07:35

    Matt -

    Unfortunately, I will not be going with him. That was a tough call for us to make; as I have always been by his side in such things. If, after his tests/evaluation on the 13th, he is a candidate for surgery or a procedure, we decided it would be more important that I be with him then. If that is the case, he would have to turn right around and have it done in December because of the insurance changes taking place within the company in January.

    A side bar to "Cigna" insurance here - which will be our new company - I was given some 'scoop" by the referral department of our primary care physician concerning out of area referrals/procedures under Cigna. She told me they are very uncooperative when it comes to seeing doctors outside of the area they 'assign' you; and it is nearly impossible to receive benefits.

    So, if hubby is a candidate, like I said, then we would want to play it safe and have it done while still under our previous coverage.

    Not to be the bearer of bad news here, but thought you might like to know what the doctor's office told me. I don't know if it has any merit - there was nothing that stated that on their website... so, I have no facts on the matter.

    At least hubby will have his sisters and parents close by (they live in that area)when he goes to Cleveland in November. They have promised to support and assist in anyway they can, so he won't be all alone in this.

    I'll have to settle for being with him via a cell phone...

    Karla

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    [Re: Good News!]

    Author: Matt (---.disney.com)

    Date: 10-17-02 12:17

    Karla,

    I'm afraid that I know first-hand that the "scoop" on CIGNA for out-of-area referrals is terrible. My appeals were rejected so my trip to Dr. Maron was never covered. They only cover out-of-network procedures if it is an "emergency", such as an accident. They don't consider seeing an HCM specialist an emergency since there are many cardiologists within their network. I am also under the suspicion that they are even stricter because of Disney.

    So I hope your husband's trip goes well and if he does need any procedures, he can get them by the end of the year. It's good that he's going to finally get the correct information on his condition with a course to take.

    Take care. Matt

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    [Re: Good News!]

    Author: Sarah B--Board Moderator (---.client.attbi.com)

    Date: 10-17-02 13:28

    Dear Matt

    Is that Cigna's HMO option? I am in CIGNA's PPO and despite one misunderstanding about "re-pricing" contracts, they paid for all of my 4 Mayo trips, no questions asked. I racked up 70K that year, and I paid only my out of pocket portion of 2K.

    PPOs are just the only way to go. In my opinion --assuming they are an option.

    take care,

    Karla ---good luck with everything!!!

    S

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    [Re: Good News!]

    Author: Matt (---.disney.com)

    Date: 10-17-02 20:10

    Sarah,

    Yeah, It's the HMO and beginning in January PPOs are no longer an option for us. My only other real option would be the 90% plan, but I can't afford to pay 10% of a heart transplant! So I must stick with the HMO. Fortunately most of my future procedures/visits will be in-network so everything should be OK.

    Matt

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    [Re: Good News!]

    Author: Karla (---.proxy.aol.com)

    Date: 10-18-02 09:09

    Matt, Sarah -

    Yep, afraid the insurance companies are calling the shots here...we are in the same boat as you Matt...that 90% plan is not an option for us, either. Certainly not thrilled about this whole HMO thing, but seems as if we don't have much of a choice.

    Thanks for your input!

    Karla

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    [Re: Good News!]

    Author: Erica Stolzenberg (---.biz.dsl.gtei.net)

    Date: 10-18-02 09:30

    • HMO quality of service complaints - 404-657-5728

    • Health Insurance Consumer Advocate, Cathy Steinberg - 404-463-1010

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    [Re: Good News!]

    Author: Erica Stolzenberg (---.biz.dsl.gtei.net)

    Date: 10-18-02 09:47

    Can you look into disputing this? I would think you have the right to appeal.

    I did some research for you found out that you can make a complaint about your HMO. To get a copy of the complaint report, call (888) HMO-2219. Hope this helps!

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    [Re: Good News!]

    Author: Sarah B--Board Moderator (---.client.attbi.com)

    Date: 10-18-02 10:24

    Dear Erica,

    That was really nice of you to look that up.

    Sarah

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    [Re: Good News!]

    Author: Erica Stolzenberg (---.biz.dsl.gtei.net)

    Date: 10-18-02 11:23

    Sarah ... it was/is my pleasure! I love educating, learning, research, science, medicine ... I love to learn, period! This is part of why I left the teaching profession ... I wanted to be on the other side ... you can only learn so much as a Middle School Teacher ... and eventually you envy your students and desire to be on their end! So this is what I enjoy ... helping others, learning, sharing etc! If anyone is strapped for time and you need someone to do some preliminary research ... let me know! I would be glad to find the information for you ... you can do the sifting part and determine which materials are relevant! TGIF! ~ Erica

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    [Re: Good News!]

    Author: Mary Sharp (---.net157.fl.sprint-hsd.net)

    Date: 10-18-02 21:44

    I am unfortunately apart of this club to that is why I am having the Implant on November first otherwise I could never afford it. at 8.50 an hour I can't even pay rent with these type of rates. I rattled off a quick estimate of some of the things that I have had done in the past nine months and it equals 5000 dollars more than I have now. I have only made about 11000 so far this year. I don't know what I am going to do.

    Lisa, I think your Mickey Mouse club might need some help!

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    [Re: Good News!]

    Author: Karla (---.proxy.aol.com)

    Date: 10-20-02 07:22

    Erica - thank you for that information. Our insurance has not changed as of yet, so we are not into the 'appeal' process; but I have a feeling that information will be useful in the near future!

    As Matt stated, come January, PPO's will no longer be an option for us. Oh sure, they offer the 90% plan- but that would cost around $55 a week for coverage! The sky-high rate doesn't leave much of a choice.

    Hubby did hear something about a 'continuing care' clause...i.e., if you have a pre-existing condition or illness, that the new insurance company must continue to pay for follow-up treatment, but we don't know all the particulars and are researching it.

    It would appear that those of us in the "Mouse club" are scrambling to do what we need to do before the first of the year.

    Mary, I empathize with you! Wish you all the best with your upcoming procedure.

    Karla

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    [Re: Good News!]

    Author: Erica (---.atlnga1.dsl-verizon.net)

    Date: 10-20-02 09:45

    Dear Karla ... I have more information to share! I just don't have the facts with me yet ... I left it on paper at my parents house last evening ... but there is aparently a program that works with families with heart problems and bills and assists with the payment process? Something of that nature ... they HELP out families ... I will post again later when I have all the facts! Smile! Everything always works out in the end the way it should! You just have to have faith, giggle, and smile! : )

    ~ Erica
    NOTE: This is a post from the previous forum message board.

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