I was approved, and then denied

I really don't understand this. They originally gave me a preapproval, pending I meet certain requirements. I met all of those requirements, and now they are stating that this is a surgery that is not covered. I don't get it. I am so upset for me. I feel like it's all over now. Every chance for happiness is gone.

what type of surgey are you wanting? dont give up sounds like someone there doesnt know what they are doing. call them tomorrow and get the nitty gritty about what is going on. Jan

I am sorry to hear that. I have no words of advice, as I mine information has not even been summitted yet. I can however, pray for you, that this was just a mistake on someone's part. Jan is right, I have read other profiles on here, where just this thing has happened. My understanding is that most places have you call your insurance company from the get go, and find out if there is absolute exclusion, before you go through testing and what not. This is not the end of the line. Call your insurance company again tomorrow. Take Care Becky, and you are in my prayers tonight Diane

I'm going to call again tomorrow, but I called two more times since this post today. Apparently, the person who gave the info over the phone for the pre-determination that was mistaking. They said that I can appeal it, but that my policy is very strong in this area.

You'll need to dig up your policy booklet on this one! Sometimes there is an iron-clad exclusion. SOMETIMES, there's an exclusion with a loophole (like saying "except in the cases of extreme morbid obesity" or "unless medically necessary"). Again, call the insurance company and ask them EXACTLY what the policy states and question whether there are exceptions to the rule (as I described above). Also, they SHOULD have it marked in your file who you talked to, when you talked to them, and what answer they gave you (the preapproval)...you might be able to play that angle because it was their mistake. You aren't out of options, unless your policy says "absolutely not" (which is why you need the book...you need to see it in writing for yourself, not take someone's word for it). Hang in there, and good luck! Pamela