EXCLUSION in Policy is there any hope...........
Hello ,
I just wanted to find out if anyone has any ideas on how to get my surgery approved regardless of this exclusion. I am at my wits end. I have many co-morbidies, and a bmi of 47 and letters from specialists, my
primary care DR, as well as friends and family. My mind set is doing nothing but getting worse. Its at the point I dont even want to get a go to work in the morning. I am so tired of being sick and tired. WHY WON'T THESE INSURANCE COMPANIES UNDERSTAND THAT THIS IS A DISEASE AND NOT JUST A COSMETIC CHANGE. They will all cover drugs and alcohol but not WLS. I just dont understand.................
Lindenwold NJ
Joe
Joe,
Exclusions can be overriden they just take some work.
Is your insurance through your work.. contact your HR specialist.. have them send you a copy of the policy regarding wls and the exclusion, they may refer you to the insurance company... usually if the surgery is medically necessary they will by pass.. there is probably an appeal process to go through.. if that doesn't work.. seek our legal assistance.. the lawyer on this site are helpfull and have good info on their site. YOu have your work cut out for you thats for sure.. Good Luck,
DJ