panniculectomy exclusion... help and ideas PLEASE

so I was denied by BCBS PPO NEPA because the panni is a group benefit exclusion.

Does anybody know what to do next?  is there anything I can do to get the exclusion lifted? Did anybody have success in going against the employers member group medical contract?

right now I feel so helpless... dont know what to do.. or how to fight this. Please help. Thank you. Karin

If it is group benefit exclusion that means your husband or your employer has chosen not to cover that particular procedure.  You have the right to appeal, but if is is a group benefit exclusion your chances of getting that exclusion lifted is pretty slim.   Sorry to be the bearer of bad news.  I would suggest appealing with all the medical necessity information.

During your open enrollment period, you might want to check if your employer offers more than one health insurance option.  If they do, you might want to check to see if it is covered with that plan.  It may cost you more in premium, but in the long run, it might save you money if you can get most of it paid by insurance rather than paying for the surgery out of your own pocket. 

thank you for your reply. I am pretty bummed out, as you can imagine, I worked so hard to get the weight off.... and now I am stuck with a panni I cant stand!  oh well... SOMEHOW I will get rid of it,and if I have to save up the $$ for a year or two, then thats what I'll do. Karin

 I don't see how you can go up against the employers group contract.Your employer chose to exclude this benefit because they get a cheaper rate. even if they didn't have this exclusion it still doesn't mean that the panni removal would be approved. It has to be proven that it is medically necessary and in most insurance co. rashes have to be documented and pictures taken sometimes for up to 6 months. even if they cover the panni they usually don't cover the muscle tightening.
the other thing you could do is get a credit card with 0% interest for like a year or so
Good Luck to you