graceland630

Hi everyone! My name is Christi and I am a complete newbie to this site - this is my first post. I have been going to an endocrinologist for nearly 6 months, and my weekly appointments include consultations with a dietician, physical therapist, and psychologist. I have not had success so far, and my doctor has suggested lap band surgery as a tool for my weight loss. At first, I struggled with a sense of failure at having to turn to surgery in order to succeed at weight loss, but when I finally realized that it was a TOOL and not 'giving up,' I found out that our insurance doesn't include lap band surgery. I received the following from the HR lady at my husband's employer: "I understand your frustration and concern but, as I previously stated Lap Band surgery is not a covered benefit under our plan. Unfortunately there is no one at the insurance company that would tell you otherwise. I would suggest that you have your doctor intervene on your behalf and ask them to appeal directly to the insurance company regarding the matter and while I cannot guarantee the outcome, it may be worth a try." Can the insurance company change the benefit based on input from the physician? Has anyone had success this way? If it makes a difference, we live in Indianapolis, Indiana, and our insurance is through Aetna. I could really use some help, as this is completely unchartered territory for me! Thank you, and I look forward to talking with all of you!! Christi

Thank you so much for the quick replies! I will call Aetna first thing in the morning and find out where I stand and where I need to go from here. I was just so excited that I had made the decision - then, to find out that it wasn't covered was just heartbreaking!! I'm hoping if the HR lady thinks there could be some appeal process, that there will be and that it will be successful. I know that if it's meant to be, the good Lord will provide! ) Happy Holidays, Everyone!!