Question:
How do you appeal if ins. comp. said I cant?

I have bcbs fl ppo blue choice since Aug. 2002 I had no pror ins. before and had nor sen a DR. for any thing since May 2001 bcbs keeps saying I have to wait 12 months b cause of Pre-existing but i dont have pre existing their policy states that it isnt pre existing as long as its not 6 months prior that i was seen by anyone anyway they say I still have to wait the full 12 months they say I cant appeal because it wasnt really denied sorry so long but does anyone know how I can appeal their decision even if they wont send me appeal package?    — marie M. (posted on April 7, 2003)

April 7, 2003
I looked at your profile and see that you live in Florida. Go to www.florida.gov. That is your state's website. Look for the insurance commision, or the insurance division or department (it's different from state to state) and call them. They should be able to tell you whether what your insurance company is telling you is legal. If it isn't, you might want to call the insurance company back and let them know that what they're doing to you isn't allowed.
   — garw

April 7, 2003
I am not sure if they denied your surgery request due to pre-existing or something else. But I can tell you that one of the requirements for approval for WLS is a 12 month Medically Supervised Diet. If you haven't seen a doctor since May 2001 that might be a problem. If they are saying that you have to wait 12 months due to the pre-existing....get yourself to a doctor and get on a Medically Supervised Diet, so that when you are eligible you will have everything you need.
   — Sharon H.