company has an exclusion in policy

Company will not let insurance pay for it . IS there anything i can do Doctors say i should have it. IS ther away ican finanace it. please heip

I'm in the same boat,my policy had the WLS exclusion, so I understand the need for the surgery and the disappointment when you find a road block. I just switched med insurance for 2006. It was open enrollment time at my husband's company and I switched to one of the insurances that didn't have the exclusion to the policy. I still have to wait until the new year to get things started, but there's a little hope. You might want to see if any other insurance is offered that might cover it. Another thing, I just went through lots of nonsense about that exclusion thing...check into it thoroughly! Is it an HMO out of NJ? Is it self funded or fully funded? The reason I ask these questions is there is a mandate in NJ that prohibits exclusions of WLS from HMO's doing business in NJ. If the policy is fully funded, it has to abide by state laws. There are lots of loop holes and the insurance companies are not about to tell you about that mandate. Look into it, you might be one of the few who benefits from the state mandate Torture the insurance company before you finance the surgery. Good Luck, Laurel

the total cost for a DS is 11k, in Brazil, which is the most expensive option, so a rny or a band might be more resonable. come to the ds forum and inquire about it thier, going to brazil or mexico,spain is common for the ds as it is more wide exclude than the rny, and for some prefered, in my case, it is the only option, cannot have the rny, surgically incompatiple