Insurance Co denial

Hi Sue How is the appeal going? I was denied this last week also, but I, as you, will fight as hard as I can. I have signed petitions, e-mail everyone I can think of. Like Attorney's General, Dept.. of Public Health, the Governor, Richard Simmons, prsidente Bush and etc... I am planing on sending it on Monday together with my doctor's papers. Good Luck to all of us fighting another battle. Take care, Patty PS: DID YOU KNOW THAT YOU CAN SWITCH INSURANCES AND IF YOU HAVE BEEN WITH THEM FOR MORE THAN 6 MONTHS THERE WILL BE NO QUESTIONS ASKED?

Hi Patty, I have been working on the appeal letter all wee****ep tweaking it- trying to make it so good that they cannot possibly say NO again. I also found a "benefits advocate for employees" at our home office and if denied again, he seems more than willing to help me out. I have accumulated alot of info this week regarding the benefits of the surgery and am planning to use alot of that in my letter too. I am sure that our denials will just make us stronger in the long run! My plan is to keep my CHINS up and fight! I will change insurances if need be on 1/1/07. Keep STRONG and Good Luck to you too! Sue

Hello again Sue I was wondering why your insurance denied you, I thought they could not deny anyone in MA.

Patty, I was told that the language in the plan excludeds any weight loss surgery. In fact, when they sent me the print out- it is black & white, they do exclude it. The problem I have is that they had given a preliminary OK back in April for the surgery. My docs think that I will prevail because I have those other medical issues and being obese is actually on the tail end of my problems. You are the last person who has mentioned the NO DENIAL in Massachusetts thing. I might need to check into that! Thanks, Sue

I was told by my own insurance that in Massachusetts, WLS CANNOT be denied. Please call the State Board of Insurance and get them involved. Big companies can have the exclusion written in the policy if they are employing employees nationwide but there are exceptions to the exclusion when the State gets involved. So get them involved. Keep us informed.