anyone have success with Intermountain Healthcare??

Hello - I'm new to this board and this whole process. I've lost weight and gained it all back (and more) at least 3 MAJOR times. I've finally decided that I need to have WLS but my insurance (IHC) has a written exclusion. Is an appeal a waste of time? I need to decide if I should push them to cover or look for a job with insurance that WILL cover, as I see no way to self pay. Please, any ideas and suggestions are appreciated.

Laurel: I don't have any idea if IHC is near to any bending of their exclusion on WLS but I had WLS on Nov 8th. Dr McKinlay with the Rocky Mountain Associated Physicians was my surgeon. I would suggest that you call their office at 268-3800 and ask to speak with Kim Kundick who does their education classes. The first time I met Kim during an introductory class she mentioned that they had made progress with another insurance company who also has an exclusion and they had actually approved and paid for a surgery. I believe it is the insurance company that insures Utah State employees like school teachers...(don't remember the name right now). Any way she would have the best idea I think on whether it is a waste of time or if not what steps might have a chance with IHC. We were insured with Althius in 2004, who also had an exclusion clause but were unhappy with them because they refused payment for some weekly covered medical procedure(s) but decided to change to a different plan during the open season for 2005 and were able to get coverage for it through the option we chose. Lucky for me when in June, I started looking into WLS that the new plan (Fed BXBS) and after August 1st Medicare both profide coverage for it. Any way best wishes, Marva

I worked for IHC about 2 years ago and I had IHC insurance. They are very hard to deal with. I gave up and got a different job with better insurance. I would appeal it and get a lawyer if you need to.

I work at iHC. I have to wait 8 more months before I qualify for gastric bypass. I am trying to appeal it now, but recently got denied.. I was thinking of appealing again..