:-@ Insurance woes - PLEASE HELP!!!

I called my insurance company to verify benifits before I contacted a surgeon and was told that Bariatric surgery was a covered benifit at 90% after a $500. deductible. I proceeded to see a surgeon, have numerous tests and prepare for surgery. I had a call from my Dr.'s office that my paperwork was in and everything looked good, but that the insurance company needed a nutritional evaluation. Then 4 days later I get a call from my Dr's office saying that they got a letter stating that my policy did not cover ANY weight loss regardless of more severe underlying problems. I called the insurance company and was told by 3 MORE people that it WAS a covered benifit before finally reading them a portion of the letter at which time they put me on hold for a very long time and then came back and said, no it was not covered. I have since appealed and am awaiting a response from them. Has anyone else had this problem and did you have any success in getting a favorable outcome?

I, too, am worried about the whole insurance thing too. I work for a school system and under State Merit PPO, no bariatric surgery is covered due to a written exclusion. I have been told that the Blue Choice HMO DOES cover it. I'm going to change insurance at Open Enrollment (April) and pray that I have been told correctly. If anybody has had similar experiences, please let me know. I hope you get it all straightened out. I would suggest that the insurance company supply you in writing the reason it is being denied so you have a firm ground to being your appeal. GOOD LUCK! Robin

I WORK FOR A SCHOOL SYSTEM ALSO. IN JACKSON CO. - HOSCHTON GA. AND I STARTED OVER 2 1/2 YEARS AGO THINKING ABOUT THIS SURGERY. I HAD BCBS PPO, I CALLED THEY SAID THEY DIDN'T COVER IT . I CHANGED TO BCBS HMO IN APRIL 2003. I STARTED GETTING MY "STUFF" TOGETHER IN JUNE , ON JULY 1 , I WAS COVERED , IT TOOK TILL DEC. 18 BEFORE THE DOCTOR'S OFFICE HAD ALL THEY NEEDED TO SEND THE STUFF TO THE INSURANCE. I HAD TO GO TO A WEEKEND EATING DISORDER CLINIC. ANYWAY , I WAS TOLD BY THE INSURANCE CO. I WAS DENIED. THEY WOULD NOT TELL ME WHY. I'M 100 POUNDS OVER WEIGHT AND HAVE DIABETES AND HIGH BLOOD PRESSURE AND EVERYTHING ELSE UNDER THE SUN. I TAKE 14 PILLS A DAY AND 2 INSULIN SHOTS. MY DOCTOR'S OFFICE TALKED TO THEM FRIDAY, AND I HAVEN'T HEARD FORM THEM YET. SO , IT'S BEEN A LONG TIME FOR ME AND I STILL DON'T KNOW ANYTHING. I'M GOING TO KEEP TRYING !! YOU DON'T NEED TO GIVE UP, THAT'S WHAT THEY WANT US TO DO !! GOOD LUCK, JUDY