insurance woe's

  Hello All

 I could use some advice and some support.

  I was approved for lap band surgery with Highmark bcbs from penn. After a 6 month supervised diet a physch evaluation and several other hoops do to my health. But they finally approved me in June to have the Surgery, But my employer switched Insurance co in July to a company that will not cover it. Anthem bcbs of Ohio. They say they have a Written exclusion and there is nothing I can do. I was told in june by our Insurance broker in June that the coverage we were swiching to was the same but as you can see its not.

I spoke to my employer and they said its not there exclusion its anthem becuase we don't have a 100 employees at this branch.
I talked to Anthem and they said since its an exclution that there is no appeals process, this sounds like a lot of double talk is there anyway around this
please help

Thanks
TM

Iknow it sucks but from what Iunderstand no there is nothing you can do if they dont cover it. but you might try asking your question in this in the insurance help area there are so many helpful people there.

 Odd that your employer says that there is none, but the insurance company says there is.  I would ask your employer where he/she is getting the info from and if it you can see it.  I went through the same exact thing, but submitted anyway and was approved.  I worked with the insurance broker and the insurance company.  I had to appeal once and it was approved after the appeal.  You really need to document everything you are told and everyone you talk to and when.  Then if you are denied you have all the documentation to provide.