Approaching Self-Funded employer about needing surgery?

stephybottom
on 1/8/08 2:26 am - New Richmond, WI

I already know that my employer is self funded, with an exlusion for "bariatric surgery related to the treatment of obesity" and that I will have to appeal to my plan administrator for any chance of approval. (Third Party Admin is Preferred One)

I was thinking of going directly to my administrator and explaining the situation and ask if the exclusion applies to medically neccesary morbid obesity and/or co-morbs also.

Will doing this help or hurt any future formal appeals? I have only been with this employer for 3 mos.

Thank-you!!

~Steph

Cathie N.
on 1/8/08 4:05 am - Augusta, GA

I can tell you from experience that it certainly doesn't hurt to develop a good relationship with your benefits analyst / HR person.  Cathie

 

(deactivated member)
on 1/8/08 5:23 am
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