Question:
Is there any thing I can do if surgery is medical neces but not covered benefit

I have gone through all the presurgery test. There is no question that it is medically necessary but not a covered benefit under my plan. I have appealed to my employer but there is nothing they can do. I don't understand how something so important to ones life can not be covered. I feel the surgery was my last chance at a normal life. Now where do I go?    — Rosemary S. (posted on September 17, 2001)

September 17, 2001
If I did not have insurance coverage for my wls, I would borow money for it. Take our a home equity loan, take a second job,have a garage sale, sell any jewlry or valuables etc, any thing to find the money to pay for it. Nothing is more important than your life. One of my local surgeons has made arrangements for low cost loans to pay for their wls. Good Luck,
   — [Anonymous]

September 17, 2001
Have you appealed the decision formally ? What does your exclusion say ? Are you qualified for Medicare ? If you have Medicare as your secondary insurance, Medicare does cover the RNY and the BPD/DS.
   — Anita N.