Juciilyps:) 67 Posted August 17, 2013 Has any sleevers that had an exclusion on ur policy but had it reversed on appeal... Share this post Link to post Share on other sites
sleevethefatbehind 95 Posted August 17, 2013 Sorry to break it to you, but my clinic said if there's an exclusion, then it's not going to happen through your insurance. Good luck 1 bigbeauty78 reacted to this Share this post Link to post Share on other sites
RebecaSparkles 247 Posted August 18, 2013 My clinic manager told us to get a lawyer & they have a local firm that they work with to get it overturned. Your insurance cannot exclude wls but cover things like diabetes or pregnancy. A few hundred or thousands are cheaper than self pay here or Mexico. Plus you get follow up care covered. allons-y Share this post Link to post Share on other sites
Tiny One 223 Posted August 18, 2013 This coming from a health insurance "patient" advcate: Ok, as far as your insurance excluding the WLS, there could be a number of reasons for the exclusion. It can actually be excluded, not unless you are in a state that has some sort of mandate that forbids excluding WLS. You first should find out if or how your employer excluded it from your plan. If your employer excluded it with no exceptions, then your insurance carrier isn't permitted to cover it as they must abide by the plan design as approved by your employer group. Perhaps it's covered for certain medical conditions or not. Have you spoken with your benefit rep? How is it listed in the summary of plan description that you received from your Benefits department? You may want to look into it thoroughly first before you spend money on an attorney. It may be a no win battle. But good luck. Share this post Link to post Share on other sites
