NO RIDER

I RECENTLY POSTED ABOUT NOT HAVING THE BARIATRIC RIDER ON MY INSURANCE BUT, HAS ANYONE ELSE OUT THERE EVER HAD T HAVE THEIR HEALTH OVERIDE THE INSURANCE COVERAGE? IF SO? HOW DID YOU DO IT? AND WHAT STEPS DO I NEED TO GO THROUGH AND WHO DO I NEED TO APPEAL TO? WHEN, I SIGNED UP FOR HEALTH INSURANCE I WAS ASKED IF I WANTED THE MORBID OBESITY RIDER? WELL AT THE TIME I DIDN'T KNOW WHAT THAT MEANT? SO, I SAID WELL I WILL GET BACK TO YOU. SO, THAT WAS MY FAULT. THEN SOMEONE FROM HR CAME AROUND SHOWING EVERYONE THAT THEIR RATES WILL BE GOING UP? DID I STILL WANT THE INSURANCE NEVER SAID, A WORD ABOUT THE RIDER GOING AWAY AND KNEW THAT I WAS SEEING DR. ANTHONY TERRACINA AT WEIGHT LOSS SURGERY AND HAD EVEN WENT THROUGH THE PYSCH TEST AND WAS GOING TO F/UP W/HIM WHEN, CAT W/SURGERY CTR CALLED ME AND ASKED ME IF I HAD THE RIDER? AND I SAID, WELL I DON'T KNOW I REMEMBER NOT TAKING IT? SO, I ASKED THEM IF I COULD ADD IT ON AND THEY SAID, OH, WELL WE HAVE DECIDED TO CANCEL IT OFF THE POLICY THIS YEAR AND WE WOULDN'T HAVEN'T BEEN ABLT TO OFFER IT TO ANYWAY! I SAID, WELL THANKS ANYWAY. THAT MADE ME SO MAD THAT I WAS SO READY TO QUIT! BUT, HAVE TO DECIDED TO STAY WITH THE COMPANY BECAUSE I LIKE MY JOB AND THE PEOPLE I WORK WITH. SO, IF ANYONE OUT THERE HAS ANYTHING? DON'T HESTITATE AND SEND IT MY WAY? THANK YOU SO MUCH!
SINCERELY,
ALLISON
 

If they don't cover it - they don't. You dont' have insurance at all - for WLS. So, you cannot appeal coverage you don't have. I'm sorry I don't have more comforting words.

You can look into self-pay, traveling to Brazil or Mexico, etc.

Yeah, I know. It just ****** me off because here i have insurance and they had the rider and then got rid of it and i know i never had it but, someone could have let me known and all these people who have medicaid and medicare can get it done! No offense to those people who have that. It's just i try to apply for that when, i make next to nothing and they denied me of that!

Hi Larissa,

I see you are very active on this site and are very knowledgeable about WLS.  You seem against fighting an exclusion with an attorney.  That's an assumption!  If you had co-morbids, would you take on the fight?  Would that make a difference?  I'm insured under BC/BS of CT with Connecticut Hospice and they dropped the rider 2 years ago.  My BMI is 41, I'm diabetic, have sleep apnea, asthma, arthritis and clinical depression.  I wrote the HR manager a detailed letter pleading my case to pick up the rider again.  Have a feeling I'm fighting a losing battle but I will not give up.  I'll find out in December for open enrollment.

Again I'm assuming you don't have the co-morbids but if you did, would you seek out legal action?  If I'm getting too personal, I understand.  No need to answer if you feel uncomfortable. 

Thanks,

Maria LaPorta in CT

I didn't say it's fair, I'm just saying legally they have an iron-clad case. The only exceptions would be getting them on a technicality of the wording of the contract, so in essance, you prove it's NOT an exclusion.

Otherwise working with HR is a great idea, I'm doing it myself. I don't know how hard it will be to convince them to add the rider again, but no one will ever know without trying.