Question:
Should I appeal?

I was denied a couple weeks ago due to my obesity being pre-existing. According to BC/BS of Al I have to have 18 months prior insurance coverage or I have to wait 365 days to be covered.(I have about 4 months prior coverage) Should I bother appealing? I called them today to see what other requirements they will need after the 365 days and she told me that I have to have 2 years of doctor supervised dieting attempts and that they have to be failures. Looks like I will be waiting until Jan. 2005. Talk about being depressed. Any ideas? Thanks, Kathleen Cramer    — Kathleen Cramer (posted on August 5, 2003)

August 5, 2003
Hi Kathleen, I am an insurance agent so I need to ask - did you list your correct ht/wt on the application for insurance? (Your personnel dept. should have a copy.) If you did, I don't think the insurance co can deny coverage as pre-existing. Check with your state Insurance Commisioner. Again, your personnel dept would have contact info. Best wishes and I'll be praying that everything works out so you can have this surgery!!!
   — Tina H.

August 5, 2003
Yes do appeal. As long as you answered all the questions correct when you purchased the insurance then they cannot deney you on pre-existing. In my state there is no longer a pre-existing clause. That was done away with a couple of years ago and I say well done to them.When I purchased my insurance through BC/BS, I had to pay more for being over weight. I thought this was fair because I would cost them more money for meds. However since my surgery, I no longer require meds. In the long run this will save the insurance Co. money.
   — myra J.

August 6, 2003
To the best of my knowledge everything was correct. I was able to get ahold of the human resources department where my husband works, the main HR in WI, and I talked to a guy that said that I am covered that he is going to call BC/Bs and see what they need. He said he can write a letter of credible coverage for 18 months. He works in combination with BC/BS and the plant. If that doesn't work out I plan to go your route.
   — Kathleen Cramer

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