Not sure if I should get my hopes up ( Insurance)

Havalina
on 11/18/11 9:41 am, edited 11/18/11 10:22 am
I posted a short while ago that my husband's employer changed our insurance. The new insurance has an exclusion for the removal of any hanging skin. It does not state unless medically necessary etc. Well, I was planning to have my panni done as soon as this Dec before the change. So, I called the insurance company ( twice actually) and on both calls with two different reps, I was told that the exclusion can be waived in cases that they do believe are a true medical necessity and that the criteria has to be met. Now, I do meet all of their criteria..but I don't know! I have read many people on this board and others that an exlcusion is just that and there is nothing that can be done. It just don't make sense to me that both reps told me to have the Doc. send in everything and make sure it is shown why its medically necessary. Any insights? Should I have some higher hopes? Why wouldn't they just tell me its excluded period, if there wasn't a chance?
 VSG  Aug 9, 2010 with Dr. Shieh in Fort Myers, FL    
HW 366 Day of Surgery 334
PS: Extended TT, Arm Lift, Fat Transfer to the rear 6/6/2012.
    
Havalina
on 11/30/11 4:38 am
Just a update to say all the paper work is going out this week. It had to be sent as a hard copy with photos ect. I have with it a letter from my surgeon, gyno and primary! Wish me luck!
 VSG  Aug 9, 2010 with Dr. Shieh in Fort Myers, FL    
HW 366 Day of Surgery 334
PS: Extended TT, Arm Lift, Fat Transfer to the rear 6/6/2012.
    
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