Denied...Mary Trampler is trying her best to help!
I switched from Great West (who denied me twice) in October 2006 and immediately started the 6 month diet and exercise program that Humana said was required in order for surgery to be covered. I got a call on Monday that there is a blanket exclusion in my policy for any weight loss surgery or treatment. Mary Trampler was told in October 2006 that all I needed to do was the 6 month program and I would be covered at least 50%...now they are saying it isn't covered at all. Mary and I are both very upset and she is trying her best to get an answer...a positive one that is.
My husband's employer is switching to Anthem Blue Cross Blue Shield on May 1st...so I also have them checking the coverage for me...but it is looking more and more like I will be self-pay which is really REALLY frustrating after this year of hurdles and hoops. I wish I would have jsut done self-pay last May and I would probably have it almost paid off by now.
Please say a prayer for me. I am feeling very discouraged and hopeless.
Thank you all,
Leah
Oh Leah,
I have been thinking of you all day and was going to write you a note tonight. I am so sorry but I think you should get on the phone with Humana and have your husband's HR people get on the phone with them and tell them that they have lied to you and your doctor. Mary will back you up. It is not fair to tell you one thing and then decide something different. Go get them girl!!! You are worth it. If you can get the HR person to intervene that would be best but they may be reluctant since they know they are changing carriers. I don't know anything about Anthem. Maybe someone else will have info about them.
I will certainly be praying that someone covers your surgery.
Don't give up hope, and please know that I'm here for you any time you need a pal. Also, I'm volunteering now to be your angel, OK?
Hugs and love,
Lana
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