Appeal letter question

Elisabeth C.
on 10/14/03 7:57 am - Federal Way, WA
Hi- anyone who has experience with this, let me know if this is a bad idea or not! I would be able to come up with $10,000 towards my surgery. Should I put that in my appeal letter to my insurance? I was thinking that maybe it would help them rule in my favor, if I was kicking in so much. Let me know what you guys think!!
Kim2bthin
on 10/15/03 1:37 pm - Richland, WA
Hi Elisabeth! It is my understanding that your insurance company must follow the contract and either approve or deny based on the criteria, not the amount you would pay to "help out". If your policy is a 80/20 split and you are approved they must pay their 80% regardless of how much money you may have available to pay. I wrote a 3 page appeal letter to Group Health stating each of my co-morbid conditions and how they effected my everyday life. I also used statistics regarding the cost of obesity and these conditions. I'd say do not mention the $10K, write a good, personal letter stating the "medical necessity" of surgery and also ask any Drs you have seen to write a letter recomending weight loss. Don't give up...thats what insurance company's want us to do. Best of luck to you~Kimberly
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