successful appeal when company excludes WLS?

karit222
on 2/3/10 4:29 am - St. Charles, IL

Is there anyone out there who has successfully appealed to their insurance company even though your employer has WLS/Bariatric services excluded from your policy?  I spoke to my ins co today and she said I could always appeal and that some people are approved even though it is excluded; it just depends on the situation.

I have years of medical documentation to back me up; I was just wondering if there was anyone whose been down this path before successfully and could give me some pointers...

Thanks,
Kari
 

            
(deactivated member)
on 2/4/10 11:25 am - LOUISVILLE, KY
Hi Karit, I am actua;;y in the process of doing that right now. I',m actually appealing through my husbands employers union, and I am supposed to hear from them Feb.5th to see if they approve of my surgery. I will keep u updated.
(deactivated member)
on 2/7/10 6:35 am - AZ
On February 3, 2010 at 12:29 PM Pacific Time, karit222 wrote:

Is there anyone out there who has successfully appealed to their insurance company even though your employer has WLS/Bariatric services excluded from your policy?  I spoke to my ins co today and she said I could always appeal and that some people are approved even though it is excluded; it just depends on the situation.

I have years of medical documentation to back me up; I was just wondering if there was anyone whose been down this path before successfully and could give me some pointers...

Thanks,
Kari
 


It is verrry unlikely.  It is excluded because your employer opted not to pay the additional premium for WLS benefits.  How often do ins co's pay for services when they weren't paid the premiums? :o/

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