PLEASE HELP ME!!
So before I started anything I called my insurance company and I was told that I didn't have an exclusion to my plan. But I got a letter today saying that the surgery is not covered under my insurance plan!! I am sooo mad, if I don't have any exclusions for gastric then how is it not covered under my plan? I have BCBS of AL....
on 9/10/09 11:09 am
on 9/10/09 11:09 am
Did you write down who you spoke with? I would call them today and ask them wtf???? then appeal fi they say they wont pay
Did they tell you that it is not covered unless it is medically necessary.. a lot of plans dont cover bariatric surgery unless it is deemed medically necessary. Call them back and request a copy of your policy be faxed or mailed to you. Also ask if there is some way you can look at the policy info on the internet.. Be proactive and get involved girl. DO NOT LET A NO DISCOURAGE YOU. Dont allow them to tell you anything, you want to see everything in writing!!! Cheer up Plus reading your post sounds exactly what the policy means if it is not excluded but it is not covered it must mean it has to be medically neccesary.. Plus when you are asking a rep you have to be specific not just one question. When rep told you that your next question should have been okay not excluded but how would it be covered is there criteria one would have to meet in order to have it covered? What does my policy specifically state? Now can you send me a copy of what the requirements are for it to be considered? Can I view the information on line. Is it listed under a clinical policy bulletin, if so where would I find them online. Be at your computer at the site if your plan has one. So they can direct you there while you are on the phone. This will come to pass for you dont give up hope. Faith is the substance of things hoped for. Remember faith with out works is dead. So keep on believing and seeking. Get it started girlie