Attacking the Problem of the Lack of a Rider

darabbi
on 4/7/07 2:41 am
I posted over in the Virginia state forum that I am a person who got to the point of being scheduled for surgery and found out our policy does not include the rider needed to have insurance pay for it. How would one go about attacking this problem.  Christine posted that the lack of the rider meant it was going to be a complete "no go."  I feel that this is wrong, not just to me, but to anyone who would like to use Roux en Y or Lapband as method of dealing with the problem. of obesity.  Any advice on handling this?  I do not want to just let this lie.  My feeling is that I need to do something about about this for the sake of others. 
(deactivated member)
on 4/8/07 10:21 am

Well they are correct if it is a poicy exclusion and your company has not purchased the rider then there really isnt anything that you can do to get it covered. Most likely you're company is either too small and it wasnt even offered to them or big enough that they pay there own claims and they have chosen not to cover it. I would definately take the time and write your insurance company and let them know how you feel about this because it's the only hope for things to change in the future. In my opinion it is a form of discrimination to not cover this surgery, obesity is a desease no one wakes up everyday and says... hmmm i think i want to weigh 300 pounds and i want to deal with the whole list of health complications that this is going to bring into my life. It's wrong and hopefully someday it will change but right now there's just not much you can do about it. Depending on how much you like your job and how badly you wan this surgery you could look for a job with a bigger company and when they offer you a job just let them know you would like to get some information on there insurance policy and ask if they could give you there group number.... once you have that you can call the insurance company and find out if there is coverage under that policy before you take the job. unfortunately that is your only option.

darabbi
on 4/12/07 11:43 am
The saga continues.  I got a letter from Anthem stating I had the right of an appeal.  Which makes ask this question: how do I have the right of an appeal for a surgery that is not covered?
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