Insurance denial worrys

well I lost the last 10 lbs and met the goal but I am almost sure that the insurance company Is going to denie the claim... I looked up the policy again today and found out that they added a plan Amendant on 1/1/06 compleatly" EXCLUDING any Bariatric surgury regardless of the purpose it is preformed or proposed " I am so upset , I just cried. the plan is a self paying bc/bs/ so my husbands employer pays the claims. I am just so disapointed.I can appeal but, what good would it do? this was the only excusion listed for the whole plan! hass anyone else had to do this when their plan specifficly excluded the surgury, and they got a yes any way?????

Joann, I had BC/BS through my employer, and it had the same exclusion written in the book; however, I was approved immediately. When I called, they said because some of their policies (specifically, those for employers with less than 50 employees) do not cover bariatric surgery, and they use the same book for all customers, they put it in their, to avoid conflict for customers who are not covered. That being said, if your husbands employer is "self-insured" even if their is an exclusion, tehy can override it. Basically, when you are self-insured, the employer has the final say as to what is covered, and tehy can make exceptions. Good luck, Carrie