Up date on my post

In the denial letter it says BCBS of TN determined that this service is a health abenefit plan exclusion.  And in reading it it is not a covered benefit for my policy.  I am trying to get a my apron removed I have a 8 in hang I have gone from 311 to 170 but have been denied by the insurance company and need help with my grievance procedure.

Sadly, there is likely nothing you can do. If it's listed as an exclusion, it's just that... something that is just plain not covered, no matter the reason. I went through this when I was considering getting a lap band... they told me I could still have the doctor submit it but that since it was an exclusion, it just wouldn't happen...

Good luck to you on your journey. I eventually gave up and lost my weight on my own through diet and working out- and I'm now financing my plastics through carecredit.com. Not my first choice, but it's what I have to work with.

Exclusions are pretty much impossible to get past.  When the employer purchases the plan -- they did not purchase this coverage option.  You can do two things.  Talk to your HR to see if this benefit can be included in the future and look over your policy to look to see what is covered under reconstructive surgery.  Also, if you do find there is coverage for some reconstructive surgeries find out what your surgeon would have to do to get a peer to peer review.

But on the off chance you want to go ahead and file an appeal while I am far from an expert I would be happy to proof read your letter.  Just let me know.

Red

ok thanks I will have to look over my benefits and see what it says