Hello everyone, Last yea...

Hello everyone, Last year in September I tried to get authorization from my insurance. WLS was excluded. In November I filed an appeal with Human Resources to go to medical review board.... they said it was never received. (How do you lose a 12 page document?) Then in January 04, WLS is covered by the plan BUT only for their hospital (did I mention I work for a hospital) and only with their doctor and only for the RNY. I have asked for a copy of the plan document and have been told that I really, probably do not want it because it does not address coverage (tongue in cheek). The hospital is self-insured and offers an HMO and a PPO (which is my choice), but you get no choice for WLS? Anybody out there have an opinion? Vmay

Sounds to me that they are self insured. I would request the plan documents that address coverage again, IN WRITING, directly to the chief officer of Human Resources. cc: dept of labor in Washington, as this would be under ERISA, which is a Federal Statute. Don't give up on this. BTW, if you don't want RNY, what procedure have you chosen? Fight the good fight! Roberta