Dealing with exclusions?
I am pretty new to this insurance tango, though I've been reading through some of the other members' stories and it can be both heartening and discouraging! I've already been for an initial consult with Dr. Hamad (Magee Women's Hospital, Pittsburgh) - yesterday, actually. The office's insurance coordinator called today to inform me that my insurance does in fact exclude bariatric surgery. The provider is Anthem BC/BS Blue Access PPO. I looked up the exclusion on their website in my health benefits section. It reads: (Exclusion #28) "For bariatric surgery, regardless of the purpose it is proposed or performed. This includes but is not limited to Roux-en-Y (RNY), Laparoscopic gastric bypass surgery or other gastric bypass surgery (surgical procedures that reduce stomach capacity and divert partially digested food from the duodenum to the jejunum, the section of the small intestine extending from the duodenum), or Gastroplasty, (surgical procedures that decreases the size of the stomach), or gastric banding procedures;" Where do I go from here? Am I up against a brick wall? Any and all help would be greatly appreciated.
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