Plz Help - Appeal letter

Hello all, Well I was denied last week my surgery through insurance (CTCARE). except, the said they would cover it, until they found out my employer has an exclusion (since 1/1/03) not to cover weight loss surgeries. I would be okay with that, but I know of at least 4 people in my company who had this surgery since 2003 and was paid for through insurance. I talked to my benefit dept and they said they will not cover it, etc..i questioned them on the other 4 people and they told me they cannot discuss them. So now I am told to send an appeal letter to my insurance company and my employer for the surgery. Unfortunately I am not that great at writing essays so I was hoping anyone who had gone through this if you can help me write something, or email me your appeal letter? I am so upset about this, especially since I verified with insurance 2 times before I had everything done that they would cover it, and the fact that people I know had it done w/out a problem. I wonder if its a 'sign' that I shouldnt have it done, and do you think I can evenutally get it paid for w/ insurance? thanks so much in advance!! Dawn

Hi Dawn, You can try here to start with this sample letter: http://www.obesityhelp.com/morbidobesity/information/wlsjourney/insurance+trouble.php Another thing you might want to do is go to Information at the top of the screen then click on Library and type in appeal letter. This will give you a listing of others that have requested copies of appeal letters and some locations to get them. Good luck and I hope you get approved soon. Heidi 267/155/147

If you really want the surgery you can hire Gary Viscio. He will write your appeal. He has an extremely high success rate. I got his name from my surgeon when I got denyed. My employer also did not cover the surgery. Gary never let me get discouraged and I finally got approved. Here is his website. www.obesitylawyers.com His fee isn't to bad. I think i paid $750.00. But it was worth it!!!!! Good luck Vickie