could i loose my job?

abuddingrose
on 4/5/09 2:21 am - Essex, MD

  I am wondering something more and more as i read of insurances sues for medically necessary wls.  According to what i have seen here I have learned a few things.

1 There is a definite difference between a diagnosis of obesity and morbid obesity and that the wording of exclusions on an health insurance policy could result in a technical reason for employers to be forced to cover the surgery.

2  Employers are the ones that make wls an exclusion to keep the cost of the premiums down.

3 I have seen the advice of going to to the HR department and asking for the exclusion to be lifted.

4 many denials of coverage are  due to minor  be it deliberate or other wise human error.

This causes me to think and raises more questions.

1.  If i go to my employer and ask them to lift the exclusion or grant a rider for coverage could this cause me to be fired for reasons other than the challenge of the coverage?

2. Since there is a definite difference between a diagnosis of obesity and morbid obesity
does that mean coverage is guaranteed?

3.When speaking to my HR department asked me what accommodations they could provide so that doing my job would be easier would/could it mean that if i could prove that need for wls and ask them to lift the exclusion there would /could be no repercussions?

4  Could the Americans with disabilities act be used to force them to offer the coverage?

5.There are many people in my particular place of employment that could /would defiantly benefit from wls ( many in excess of 500+ lbs) and the benefits would out way the disadvantages and would be  willing to pay higher premiums to have this coverage.

Comments and other questions are greatly welcomed and appreciated.

never settle for less than you deserve and you deserve only the best.                            
Dannielle H.
on 4/16/09 6:12 am
I'm just now reading this, but I've been dealing with the same thing-- much of which you can read on my profile.

I am fortune;  after being denied for surgery MY employer held a meeting with the insurance company and tried having the exclusion lifted.  It wasn't feasible until the beginning of our new fiscal year, but effective May 1st it will be covered! 

I would definitely say go ask!  It can't hurt anything, and I don't *think* they can fire you for asking.  At least I sure wouldn't think so!!

Good luck!  Keep me posted on what happens!
**Dannielle**
 HW: 636 / SW: 615 / CW: 247

   

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