What am I going to do? Insurance says it's not a medical necessity.

----- Original Message ----- From: Colleen Kubat <[email protected]> : Deniel again I have this problem with Care Choices. Well I filed the certification for consultation my PCP sent in was denied. So, I filed a grievence that was denied because my doctor (who is not for it) wrote that all I had was High Blood Pressure and Diabetes, both were under control. Then I filed for an appeal in front of the Reconsideration Board that also was denied. They did say that there was a small problem from the first letter that my doctor wrote. To the one for the second hearing that did contain more information that was correct this time. They were very impressed by all the medical records that I had collected on my own as they weren't supplied any by who ever was suppose to collect it all. They said that I seem to have a good knowledge of the WLS. They asked questions. Then the Medical Director had her say all she would say was it was not a covered benefit. I already remember her from being my mother's doctor while she was still practicing medicine and my mother was still alive. The Med. Director and my PCP use to be in practice together. So I was denied again. Now I have contacted the HMO Task Force. Any help as what to expect. Also when open enrollment come around we will be changing to one of the other General Motors Insurance Plan any help there. Colleen

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