Insurance exclusion 2015. Allowed 2016
Hello all. I had surgery 10/21/15. At that time my insurance excluded bariatric surgery in Cincinnati but covered it in Cleveland. I filed appeals but of course was denied. So we took out a home equity loan and pulled the trigger.
Guess what? They are covering it in 2016! I'm beside myself and owe S15,300! Do I have any recourse? Can I sue them for coverage or something?
Thanks!
Hello all. I had surgery 10/21/15. At that time my insurance excluded bariatric surgery in Cincinnati but covered it in Cleveland. I filed appeals but of course was denied. So we took out a home equity loan and pulled the trigger.
Guess what? They are covering it in 2016! I'm beside myself and owe S15,300! Do I have any recourse? Can I sue them for coverage or something?
Thanks!
no you can't sue them. It is entirely your employers choice whether to buy the coverage for their employees or not. There is nothing to sue over,you can't win and would just be out attorney's fees.
Sadly this is a risk you took. Sorry :/
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No - sorry. They won't do anything retroactively because it was a plan exclusion at the time.
Even Obamacare.