Question:
WHY DO THEY NOT COVER SURGERY? ANYONE KNOW?

I HAD CONSIDERED THIS SURGERY ONE AND HALF YEARS AGO AND THEY SAID THEY WOULD APPROVE IT IF YOU MET THE CRITERIA, NOW THEY SAY THEY DONT COVER ANY WLS AT ALL FOR ANY REASON. I AM EXTREMELY DEPRESSED SINCE I JUST RENEWED THIS INSURANCE PLAN AND HAVE TO WAIT ANOTHER YEAR TO GET ANOTHER INSURANCE COMPANY. ANY SUGGESTIONS. I CALLED THREE SURGEONS OFFICES AND EACH OF THEM SAID THEY CANT RECALL MDIPA EVER COVERYING FOR WLS THAT MOST INSURANCE COMPANIES WILL AND THEY DONT KNOW WHY THEY DONT. IS THERE ANY USE IN COMPLAINING TO ANYONE AT MDIPA. I FEEL I HAVE NOW MISSED THE BOAT BY WAITING TO MAKE SURE THIS IS WHAT I WANTED TO DO. ANY SUGGESTIONS WOULD BE GREATLY APPRECIATED.    — [Anonymous] (posted on January 29, 2001)

April 11, 2001
How long ago did you try with MD IPA? MAMSI is a parent company and has several insurances under them MD IPA, Optium Choice and Alliance are the few that I know of. I have MD IPA (federal plan) and am in the process of trying to get approved. They will cover it according to my book, but it has to be pre-authorized by them and you need to meet their requirements. I and at the wait and see stage so I don't know if I will have appeal. Optium Choice and Alliance have exclusion clauses in their policy. I found out even with the same insurance co. there are several different plans offered. You might want to check it out again. I have looked at a couple profiles of people that were approved with MD IPA in Va. and Md. I am keeping my finger crossed for approval to be soon. Good luck to you.....
   — Betty M.

June 14, 2001
You have to be persistant. I was initially denied and sent in an appeal package within 3 days of their decision. In less than 2 weeks the denial was overturned and I am now officially approved. Their a tough company but, you can win. Hang in there and don't give up.
   — Betty M.