Any options for exclusions????

Hi There!

Does anyone know if there is a way to challenge an exclusion in a company's policy?  My husband worked for the Hoover Company, which was sold to Maytag, then sold to Whirlpool.  He retired 12 days before they closed the doors at the main plant forever.  I have gone through the second appeal only to be denied and have had no luck in being able to even contact anyone.  The insurance company just kjeeps telling me it is the comapny that will not approve it.  I have been forced to go self pay, however would like to know if any options are available.

Thanks,

Terri

As far as I know if it is a self-funded plan and the surgery is excluded you really don't have any other options.  Other than calling the Company HR & discuss it with them. Kerri

Already tried, with the change of hands, there has been absolutely no way to get in touch with a REAL person.  Oh well, I thought it was worth a post. Terri

I found out yesterday about the exclusion in our policy. It just really gets me to spend soooo much money on insurance per month and it not cover this. So now i'm trying the alternatives. i.e picking up another part time/full time job with insurance that will cover it, or what my husband suggested if i get a second job all the money from my two jobs can go toward the surgery and we'll private pay. it will just take longer that way. I am not happy about all of this.

I certainly agree with you.  When my husband retired right before they closed the plant (and thank God he did or we would have lost even more pension) we had to start paying for our insurance.  I think paying for insurance then having the company be able to decide and pick and choose what they will cover (as they are self pay) is unfair.  I tried the appeals process and more or less all this did was spin my wheels for a longer time, cost me more as I had to have some retesting and still was turned down. We are fortunate enough to have a home we can mortgage, but still scary when you know you have no income other than your reduced retirement to depend on the rest of your life.  I wish you the best of luck and hope to see you on the loser's bench soon! Terri