Question:
Anthem ppo insurance question

My insurance has an exclusion for this type of surgery for any reason. My doctor says i need this surgery. My question is has anyone been able to have the surgery and have the insurance pay even though they have denied it. And how do i need to go about it. I dont want to pay 500 to see the doctor if iam just thoughing the money away. I can not afford the surgery on my own. please someone help me your my last hope. I have my first grandchild comeing and i want to live to see it grow up.    — Caretta (posted on April 4, 2006)

April 4, 2006
It depends on what your employer is willing to have covered. I have an Anthem PPO that covers WLS because my employer was willing to pay higher costs to have it in our plan.
   — [Deactivated Member]

April 4, 2006
My neighbors insurance didnt cover it, but she fought it for three years on paper. They finally decided to pay for it. Talk to your Dr. about apeals. Good Luck
   — Jennifer Nice

April 5, 2006
If you check the questions, in here somewhere is an attorneys name that fights for the wls, I can't remember what his name is, but its in the list of questions. LOL, P.G.
   — Peggy1

April 5, 2006
I have Aetna also and I had to fight them to approve me for my surgery.... I was denied 3 times. I wrote everyone I could think of from the governor to congress men... finally one of my letters were sent to the dept of ins and I had to show that I had everything Aetna requires to approve the surgery once they saw that I had everything plus some they gave Aetna 15 days to answer why I was denied and they approved me on the 14th day. So don't give up and if you need anything let me know.....I am now 6 months out nad I have lost over 80lbs
   — thelindersmom