Need Help and direction>>>>>>please!!!!!!
I have started my journey for awhile now and i have completed my multidisciplinary regimen that was required for approval by my insurance company Aetna I am in the process of sending my request for approval to my insurance company Aetna Pos Open Access of Fl.,...but as of Sept 1, 2006 on my policy things changed for the worse...they added this exclusion now all this money and time i have invested i am not willing to take No for an answer....my exclusion reads as follows: Weight control services including surgical procedures, medical treaments, weight control/loss programs, dietary regimens and supplements, appetite suppresants and other medications; food or food supplements, exercise programs, exercise or other equipment; and other services and supplies that are primarily intended to control weight or treat obesity, including Morbid Obesity, or for the purpose of weight reduction, regardless of the existence of comorbid conditions. Now this means I cannot afford an attorney nor can i afford to take a loan out..i am a single mother of 3 children., what is my next route...i have decided to write to our insurance commissioner and senator and plead my case....i was 30 something days shy from finishing my program....I have headed towards depression but Faith and Hope in God keeps me hanging in there....today i have decided to call insurance companies in florida that do cover this and get a quote on coverage for myself....I'm confused please help?????????
Gosh you would think they would grandfather you in since you are that far along in the process. I would definately find out about that! I hate that you are having such a hard time. It breaks my heart when I read the stories soooo often here with insurance nightmares. I was so lucky to have been approved as fast as I was and to have had United Healthcare at the time of my surgery! With having said all that I don't have much experience dealing with appeals and things like that with regard to insurance. However, I do know that you should NOT give up and fight it as hard as you can for as long as you can! I would write to anybody and everybody you can and remember sometimes the squeaky wheel gets all the grease! I would raise holy H#LL and raise the rooftop if I had to! I am cheering you on and sending good positive energy your way! 
Had you checked with your insurance before-hand telling them that your were proceeding toward the WLS & your Primary might've Charted something in your records of Proof. Anything in writing? Before these New Stipulations were introduced. If so you have a very good footing and should be allowed to disregard the New Notice.
This is why it's suugested everyone get copies of everything in writing for their own records.
yes i believe so....my doctor is for it all the way., he wants this for me....Aetna has notes in their records dating back to March of 2006., of me questioning WLS and they telling me the precertifications for approval....and they also have notes in August 2006 ., I asked Aetna to send this to me and they state there is no way how.....it is notes they keep for Customer Service only.....I will call my doctors office today.,.,....thanx..if u feel like sending me a e-mail...my address [email protected]
no i wasn't given notification that renewal time was coming up.,...and since my employer pays for my premium ., i found out the hard way..going to the doctors and my co-pays went up in price$$$....i contacted the broker that wrote up our policy and it was renewed with Aetna the same company and they added this exclusion on there own..we tried to override it..but to no avail....i won't give up though...i know i have a good chance to fight this....that light is at the end of the tunnel...
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