I got denied

Well i called the insurance company and i was denied because of the stupid exclusion we have in our plan. I asked if i could appeal and she said i could but it probably wouldnt do any good because of the exclusion made by my company. Does anyone have any suggestions to help me through this??? I dont understand why people dont understand why we need this surgery to live a healthy life. Its like they dont care if we die or not. Gosh i am so upset and frustrated right now. What a way to start off my weekend.

Katie if the exclusion was made by your company, then you need to go to your HR/Benefits department, they are the only ones who can help you. Good Luck and Hang In There... Debby

Debby... Yes i did talk to my HR person when i first found out about the exclusion and she said she didnt ever see it getting approved. Blah on them!! Right now ive decided to file a complaint to the Office for Civil Rights and see what that does. Let me tell you im not going to give up without a fight.

Kate - I got denied too and I am very upset over it. I do not have an exclusion in my insurance so I need to meet with a dietician for six months and jump through some more hoops and then hopefully I will be approved. Have you thought about the attorneys at obesitylaw.com? I contacted them when I got my denial and they thought that they could beat it but I could not justify the money that they wanted when I could do it on my own by just meeting with the dietician. Anyways, good luck Nancy

Oh honey, I'm so sorry. 2 years ago when 1st starting looking into the surgery, there was an exclusion in our contract. I was told no-way, not even to bother - I even called a lawyer who told me the same thing. My luck was that our insurance company was sold to a different parent company in 2003, and the contracts were changed, and they starting allowing them. I wish I knew what you could do. I will be thinking of you!

hey there im so sorry to hear about your denial. my sister in law has healthlink and im worried for her.....although when she called the insurance company they did say they covered it as long as it is medically needed. did they make you wait 3 weeks before they would tell you anything? the case manager she has to deal with is a witch and told her she would have to wait for three weeks. and it didnt matter how many times she called ...she wouldnt know anything for three weeks. is that right? well hang in there and i wish you all the best! tracey

Hi!! I also have an insurance plan that specifically excludes this surgery. I am going through Illinois Dept. of Public Aid. They do cover it and you can be approved even if you do not meet the financial guidlines. (I'm over) If your over the guidlines financially, your spenddown will be higher. (mine is almost $3,000.00!!) but that's better than paying the entire thing yourself!! Problem with this solution...there are very few Dr.'s that "take" public aid (medicaid). I e-mailed a Dr. Alverdy in Chicago and he told me that in Illinois it is illegal for a hospital to not accept a patient because they are on medicaid. Didn't say anything about Dr.'s though.He does take IDPA and told me to call him for an appoint. My problem is that he is so far away. Chicago, and that's about 200 miles from me. So I am still trying to find someone a little closer that don't have a year or longer wait!! Hope this helps! Teresa