Denied, Pre-existing Condition/Lapse in Insurance: Should I Appeal???
I have Blue Cross Blue Shield/Blue Choice since August & pay $156.00 a week. There was a three month waiting period, before my husband could apply for the insurance, in the first place (there can't be a lapse in coverage more then 63 days) we had a lapse of 180 days, counting the 90 days he had to wait to apply for the insurance. Before he got this job we couldn't afford health insurance, (in between jobs) without him working (I can't work/medical}. First of all you have to have a per-existing problem to even get this surgery, also the insurance company wouldn't let us get the insurance as soon as my husband started work. They said he signed papers stating this clause, there is nothing in the papers he signed. We've never had a lapse in insurance before this. They told me, I can have the surgery after one year. They told the Doctors office it was the pre-existing condition, plus they don't approve this operation. They DO approve this operation, it is in the coverage book. Has anyone had this problem and tried to appeal it??? If so what happened? I don't want to put myself though this unless there's a chance. It took over three months to even get the doctors office to turn in my paper work, then the insurance company to answer. They paid for my pre-op doctors visit, etc. They pay for my primal care doctor and also medicine I take (for pre-existing conditions). It doesn't make sense to me... What do you think??? [email protected]
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