SO ANGRY! (maybe more dissapointed...)

I went to my PCP on Thursday and we talked about WLS and she is on board.  (She is also my boss so this was a tough conversation to have)  She told me that she supported my decision and would do anything that she could to help me out.  She also told me to to go ahead and call my insurance company to make sure that the surgery was covered and to call and make my apt.  I was all excited and ready to take the next step.  I called the ins company to ask. She informed me that we had NO COVERAGE for this type of service.  OMG! Why do we pay all that $$ for!?! The Tufts rep actually told me that she 'has never seen a company choose to not cover this'  Thank you very much Comcast!  This also happened to us when we were going for fertility treatments 6 years ago.  They accidently covered some of the treatments and then in the middle of an IVF cycle told us they made a mistake and shouldn't have covered anything because "Comcast elected to not include fertility treatments in their covered benifits"  When this all happened I bought a private BCBS insurance and paid over $300 a months for it.  I am willing to find a way to do this again, but 2 kids later and only working part time, its a little different this time around.  Has anyone had a simular situation? I am at a loss right now- Corporate America at its best, right?

I'm sorry to hear this, fortunately for me I don't have this problem.  Sounds like Comcast is cutting corners left & right.

Does your company offer other Insurance plans?  I had to change my plan during open enrollment.  My company has several different plans and I called around and switched to the plan that had the best coverage.  I wish you luck in your weightloss journey, it's not easy!  Maybe you can call your company headquarters and inquire why they aren't covering this service. 

 Hi!  I'm in Worcester.. would love to meetup and chat if you're interested.  

Check out UMASS, that's where I went.  My understanding is that everyone there pays a fee of $350, whether they are covered or not.  Now, I'm not sure if they have additional fees for people without insurance, but for some reason I seem to think that's why everyone is charged that fee, to offset the $ for people without insurance.  Give them a call (let me know if you need the number!) and find out if they have a program for people without insurance.  

I am a bit confused.  If you work for Comcast, then why is she your boss (your docotor?)  and if you have private paid BCBS then why are you talking about Comcast's insurance.

I was under the impression that in the state of MA, they HAVE to cover ferility treatments?  So that being said, DO NOT TAKE A PHONE REPS WORD FOR IT.  Get a hold of your policy yourself.  See what it says for exclusions in writing. 

Dont stop at where you are.  Also, can you see what other policies Comcast has?

Clare~ My husband works for Comcast, not me.  I have Tufts through his work and when I was going through fertility treatments, I bought a BCBS plan.  As far as MA having to cover fertility treatments, you are right but because Comcast is a PA company, they don't fall under the same rules/regs.  I can look into the other plans, but I think that if they chose to omit the coverage from one company (tufts) they most likely did it with the others they offer too. 

I am going to try Alli for a month and see what happens.  I know its nothing like WLS but I just can't swing the $400 a month that buying another policy would cost right now.  Our kids are starting private school in the fall and we have a tution bill now....soooo upset about all this.  I wish I were rich....or on MassHealth, funny, the more money you make, more you pay for insurance, the less you have covered...something is so very wrong with this system.

I would call your husbands HR department.  When I had my surgery, my company was self insured.  I spoke with the HR department and had to get a letter from my primary as to why I needed the insurance and once they received this information, I was approved in 2 days.  Also, find out the policy where it says that the insurance will not pay.

As far as the fee at UMass, the fee is a program fee that everyone has to pay that is going thru it.  From what I remember, it has nothing to do with insurance.  It covers the dietician, psy, nutrition appointment.  I had to pay it before I started.

I had fallon when I had the RNY..at St. Vincent's and never had to doubt the coverage, but last sept our company changesd to TUFTS..I had my PS ask TUFTS for an approval to remove my pannis..it has been long enough and all the pre-recs thay want...I got a denail dated 2/17, and then the next day got an approval with auth # date 2/18.  I work in a nursing home and deal with insurances a lot so I called TUFTS and they assured me I was covered.  I called 2 more time sin teh next few months and my surgery was set for monday May3rd.  The friday before my surgery the PS office called and said TUFTS ended up denying the surgery so it was cncelled.  I was SO IRATE...I called tufts and got 2 suoervisiors and told them the story and that I had just taken off 6 weeks of work, etc...and DEMANDED they get someone to cover this..I hd all the documentation they  needed..treamtnets and dermotolgy appoinments ..I spoke with them for 2 hours and they told me that the apporval letter was a "computer glitch"  I FINALLY got them to cover it....I agree with you..I pay $104.00 a week for my tufts adn they oew it to us to cover this....have your PCP and PS do an apeal for you...email me if you need any more info  [email protected]