Exclusions in policies

I was just curious if anyone has ever gotten insurance to cover the surgery even if there is an air tight exclusion? Im trying to figure out if i even should try to appeal it or not. I have been told by many people it wont help. I just dont know what to do anymore. Tonight i just sat and cried because i am so tired of being this way and i feel like i cant get anyone to understand me anymore. I just dont know what to do anymore. If anyone could help me that would be great!! Thanks. Kate

Hello I understand exactly how you feel. I did the same thing last Thursday, when i found out that my husbands new insurance with United Healthcare had the exclusion. I was so pissed off cause my husband company had Aetna insurance first with no exclusion and then they company decided to switched to UHC in Dec 1, 2004. I did a 6 month supervised diet, paid $280 for Psychological exam, and paid a $150.00 to the nutritionist for nothing. I'm so upset right about now, that i don't know what to do. Good Luck! Amber

I have Blue Cross Blue Shield and because I am self employed with an individual policy they have that same exlusion in my policy. I was denied, and am filing an appeal. I believe that the squeaky wheal gets oiled, and hopefully if I have to file 20 appeals they'll finally approve it just to get rid of me... We'll see.

I love your positive attitude! Unfortunately, most policies/plans have a certain number of times you can appeal and then you would have to go to litigation. Check your Summary Plan Description booklet under the Appeals Process to see how many appeals they allow. Fight the good fight!