BCBS of Texas HMO

booboo60
on 12/10/09 7:35 am, edited 12/10/09 7:36 am
The dr office called me last night and said no go the ins want pay WHAT then asked me if I wanted to finance it. NO I thought the insurance depts of these dr would fight for you when it is medical needed. An mine is my heart want carry this weight anymore.  I dont know what to do now if  any one does let me know or some one that will go to battle with the insurance co.
(deactivated member)
on 12/11/09 4:27 am - AZ
On December 10, 2009 at 3:35 PM Pacific Time, booboo60 wrote:
The dr office called me last night and said no go the ins want pay WHAT then asked me if I wanted to finance it. NO I thought the insurance depts of these dr would fight for you when it is medical needed. An mine is my heart want carry this weight anymore.  I dont know what to do now if  any one does let me know or some one that will go to battle with the insurance co.

What is the specific reason they are denying you?  Not a high enough BMI?  WLS is excluded from your plan?  What is the reason the ins co is giving?

booboo60
on 12/11/09 4:37 am
It has to be written in the policy I just got off the phone with the ins com They told me I had to
contack the person at the co my husband works for and see if they could have it included.  I did not want to have to do that but I called my husband and asked him to talk to her.  I just donot thank he understands. all I cna do is hope cause I dont have the money to pay for it   
(deactivated member)
on 12/11/09 4:42 am - AZ
On December 11, 2009 at 12:37 PM Pacific Time, booboo60 wrote:
It has to be written in the policy I just got off the phone with the ins com They told me I had to
contack the person at the co my husband works for and see if they could have it included.  I did not want to have to do that but I called my husband and asked him to talk to her.  I just donot thank he understands. all I cna do is hope cause I dont have the money to pay for it   

Yeah, they have every right to decline to pay for it.  WLS is an additional premium for the employer to pay.  With the economy those that did have WLS benefits are finding that when the contract is renewed they no longer have those benefits.  WLS premiums are quite expensive.

I have self paid twice, between my own experiences and reading these boards for three years I have learned that if someone wants it badly enough, they will find a way.  Refinancing their homes, taking out loans, selling off personal items, one girl went dumpster diving daily before work and then sold her treasures on ebay until she saved for surgery.

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