Question:
Group plan has changed -

My group plan at work has recently sent out a memo to "exclude the use of surgery to correct obesity" effective Nov. 1 - that is less than 3 weeks notice - What can I do - I am 5 months into all the prelim stuff and Dr has scheduled surgery for 10-20 - I am just concerned that insurance wont make a decision in time or may deny and I will have to go through appeals - is it possible for me to buy my own personal medical coverage and still be on a group plan? Or do they perform this surgery for anything other than obesity???? Please Help!!!!    — shelbytd (posted on October 10, 2003)

October 10, 2003
I would think that if you were pre-approved, and are having surgery, before Nov. 1...when the change takes effect, that everything should be just fine. I would contact your insurance company and/or Human Resources person to verify that your surgery will still be covered though. Good luck to you!
   — eaamc

October 10, 2003
Tracey, don't despair, yet. It may be that the exculsion is for obesity only, but not for MORBID obesity. And, you might just have surgery as scheduled and not have to deal with it. You can be covered by both a group policy and an individual policy, but I doubt that an individual policy would help you much now. Chances are they will either exclude WLS, or at least impose a pre-existing condition limitation. It may be difficualt to get an individual policy. But, take deep breaths, and think happy thoughts. It may never be an issue. If it becomes one, then appeal and do whatever you have to, but don't make yourself crazy thinking about what could be a problem. Hang in there.
   — Vespa R.

October 10, 2003
Just keep on going! The same thing happened to me only my insurance provider changed and the one my employer changed to is notorious for fighting WLS to the death! Even though in Maryland the law is that insurance cover it if it is medically necessary. Mine was to change as of 7-1-03 and my surgeon upped my date to 6-25. I got in under the wire and so far I haven't had any problems pop up! Good luck - just keep going and don't look back!
   — Pambylah