My husband's employer changes insurance, new one does not cover

Old insurance was Great west, which did cover the surgery new insurance, self-funded United Healthcare, which has an exclusion (that I just found out about this week) They told us we had to switch on March 8th, effective April 1st.  I was all set to have gastric bypass.  I went through all the very rigorous prerequisites and tests and everything.  I even had my insurance processing the authorization.  Then Alex's company tells us that they're changing insurances and that we all have to change over to a new insurance.  They say it's a comparable plan..and I ask specifically if there are any surgical exclusions...anything that could hinder me.  I am assured that everything will be fine. I look over every single piece of documentation and benefit info they give us just to make sure (you and i both know how there can be fine print).  And everything is good.  So we switch insurances, and then my surgeon applies with the new insurance, and lo and behold, there is a specific exclusion to this very surgery.  And it's in a benefit summary we've never seen and was never given to us.  I talk to his HR, to the insurance, to the surgeon, to everyone..and I can file an appeal, which they'll deny and they'll be able to make it stick.  I can pay out of pocket, where I'm looking at 30,000 that I just don't have, or I can hire an attorney and most likely still be denied. I just did so much work for nothing, and I put myself through so much stress for nothing.  I've been going through t his for 8 months for nothing. I'm going to appeal, but I know it will be denied.

What about paying for cobra for a few months?? That is what I would do because I think you get the same plan as you had then. Just a thought GL and don't give up, Rebecca

thanks..i tried that one.  They told me that even those on cobra would have had to switch...so a no go.

Thank you.

Oh...that stinks! We both have Dr. Sanchez and I too have Great West..... I don't have much to say but I wanted to wish you the best of luck.   I can't even begin to imagine how frustrated you must be.

Thanks...I think it is just so bad because I was so close.  And if I'd had the correct notice, I would have had the surgeon's office move things up and get me in before the change instead of after. My authorization was being processed by great west and everything...it's just ridiculous.   

I would have a talk with your husbands HR department.  They make the rules of what is included in the plan, not insurance co.  Explain that you were already scheduled for surgery and don't back down.  Dr. Sanchez office seems to be very helpful...perhaps they can help you get this along.