Question:
I was denied because my agency did not purchase the

My insurance, Trigon Healthkeepers, is paid for 100% by my agency. No out of pocket expense for me to participate in the health plan. Three years ago a coworker had a RNY under the plan. My director was considering changing insurers this year but due to cost chose to remain with our current company. She told me that when she signed the renewal she trusted that it was the same policy as always and hadn't noticed that they removed the gastric bypass rider (which is probably how they got the rate down to a competitive figure). She called the benefits manager who said the rider couldn't be added until our next renewal in Jan. '02. When I talked to the insurance company they said I wasn't approved because my agency did not purchase the rider *not necessarily* because of medically necessary. I'm wondering, since I know they will approve the surgery, if there is any way to bypass this rider thing and get the insurer to pay?    — [Anonymous] (posted on May 19, 2001)


Sorry, no answers yet. Perhaps you have one to contribute.




Click Here to Return
×