2 years post op, insurance denied hospital stay , related to gastric bypass

Ella M.
on 12/29/05 10:56 am - Roanoke, Va
Hi, My daughter is 2 years out and went to the hospital for belly pain.She has had a bacteral infection in her bowel. My insurance denied the stay . They said that since my company didn't pick up the obesity rider that any thing realted to gastric bypass would not be covered. Any one else run into this problem? It's healthkeepers. I'm worried because I'm 3 years post op and am very concerned that if I have any belly problems it won't be covered. Is this legal? thanks, Ella
elizabeth b-c
on 12/29/05 11:02 am - Charlottesville, VA
Hi, Ella: Yes, it is legal, but don't let that stop you in being an advocate for your health, and your daughter's health. You might want to appeal their decision with letters from your surgeon, primary care doctor and possibly your attorney. If we don't push the insurance companies, they will end up denying this surgery to all of us that needed it to save our lives. Good luck - and I hope your daughter feels better soon. elizabeth 359/249/160
Ella M.
on 12/29/05 7:35 pm - Roanoke, Va
thanks for your reply. the insurance company has approved 2 days now with a peer to peer review but that still leaves 2 days and she's still in the hospital. My HR rep is gungho in helping with the battle. this really scares me. The same insurance company who let both of us have gastric bypass due to medical reasons can now say we won't be covered. thanks, Ella
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