Denied - What can I do know?

[pickel1972 2]

My insurance company has an exclusion on gastric surgeries. The state of Utah allows employers to pick and choose what procedures will be covered and not covered. I thought there may be an exception for me since its not a new surgery. The insurance gal at my doc's office doesn't seem to really wanting to dig into this deeper and help me at all. She also is assuming they won't pay for the removal if I want to have it taken out and no revision. I'm still gaining weight and throwing up every day and they are telling me I'm stuck with this band! Does anyone know if this can be appealed?? Help!

[socalfosh 17]

Idk since its specifically excluded. Try to appeal but if there's anyway to got different insurance than try that. There's always mexico, there are a lot of good reviews.

[mich 74]

Sorry to hear that. I have heard in my state (MA) that is is illegal for insurance company's to discriminate or turn down based on a pre existent condition. Could a lap band count as a pre existing condition?

I would work with your surgeon and let his/her office try to get approval. I never get anywhere calling them directly, or contacting personal at my husbands work. My surgeon said he might need to go peer to peer ( or something like that) after a denial to get it approved.

Good luck.