Insurance Company reasoning

[kmt1973 92]

I am so frustrated. My first time was denied. They said I needed to send them my weights for the last 3 years. So, of course I did. Now they said, "I'm not saying you're denied BUT.........Even if we approve you, we will not cover your surgery until January 2012. Because even though you have never been seen for your obesity, the weights you submitted show that it was pre-existing." What the heck, when I started this in March, why in the heck didn't they tell me this before I started jumping through hoops for them!!!!!!!!!

[Phranp 46]

I am so frustrated. My first time was denied. They said I needed to send them my weights for the last 3 years. So, of course I did. Now they said, "I'm not saying you're denied BUT.........Even if we approve you, we will not cover your surgery until January 2012. Because even though you have never been seen for your obesity, the weights you submitted show that it was pre-existing." What the heck, when I started this in March, why in the heck didn't they tell me this before I started jumping through hoops for them!!!!!!!!!

That is the most ridiculous thing I have ever heard! OF COURSE IT IS PRE-EXISTING, no one becomes obese overnight!!! I understand your frustration. Perhaps you should contact the benefits department at your job. Whenever the insurance company says crazy things to me that's what I do. I let them fight with the insurance co for me.

Don't give up. The person you spoke with at the insurance co doesn't seem very well informed.

Good luck to you.

~Fran

[Erika78 1]

Its a game these insurance companies play!! I swear they think if they give us enough S***, and make us really frustrated, we will just say forget it! Keep on them and keep appealing. Not sure where on this web site I saw someone mentioning a specific lawyer who specializes in this.

By the way, what ins. co is doing this? Just wondering since I am in process of submitting everything to mine for approval.....Good Luck

[kmt1973 92]

It is bcbs of Alabama. Good Luck with yours. And thanks for the advice about talking to the person at work. I hope it helps.

[Phranp 46]

It is bcbs of Alabama. Good Luck with yours. And thanks for the advice about talking to the person at work. I hope it helps.

I have BCBS of California. You should be able to go to their website and see exactly what their requirements are, take a look ... it might be helpful.

~F