Question:
Will insurance pay even though you have an exclusion in your policy?

I was told in January by Optimum Choice that they would pay for bariatric surgery if medically necessary and now they refuse to. I am looking to see if its worth the time and effort.    — its2ez24get (posted on May 14, 2003)

May 14, 2003
Please see my bio. I beat a written exclusion. It is not legal to exclude a needed surgery - this is discrimination. Fight it and they should back down. If you have any questions, Please let me know.
   — Lisa B.

May 15, 2003
I'm sorry to hear about your insurance troubles, believe me I've been going through quite a bit of them myself. Why did Optimum Choice refuse? Did they say that it was do to a "written exclusion" in your policy"? I had one of those, & fought to no avail. The best thing to do in that case is to go to the human resource department of your company (assuming your insurance is through your employer). They are the ones who have the ability to overturn something like this. Or are they saying that it isn't "medically necessary"?? In which case, you need to find out what "to them" would qualify it. A good group (that I belong to) that helps with insurance approvals is ossg-insurancehelp with yahoo. But feel free to e-mail me!!!!! :)
   — amandalianne