Confused

[Mrs.FullerRN 189]

Have a question regarding insurance. My employer offers 3 plans and 2 of them specifically state they cover bariatric surgery. However the one I have, healthplus hmo of mi says on the paper they give us that it does not cover any medication or procedure to assist in weight loss. I thought it was weird because most plans do cover so I the number on the back of my card and asked them why it's not covered. I gave them my ID number so they could look up my specific plan and the lady assured me that it is covered after all the requirements are met. I'm so confused as to why it would be listed as an exclusion but then the health plus rep would tell me it's covered. Who is more likely to be wrong? My employer or the health plus rep. I have major anxiety! I don't wanna wait til next year when I can switch plans. I want surgery now!!

[Mrs.FullerRN 189]

Sorry about the horrible punctuation I'm tired

[gourmetone 394]

Which has the shortest requirements?

That's the one I'd go with, good luck

[Mrs.FullerRN 189]

Which has the shortest requirements? That's the one I'd go with, good luck

I can't switch until January. I'm hoping to get the one I have currently to cover it

[MIPoohbear 6]

I would look up the medical policy on their web site. If you can't find it they should be able to assist.

[jujubslim 95]

If your employer says it's covered and a rep at the insurance says it's covered it should be covered. It sounds like it's an extra benefit employers can purchase. It's probably not standard coverage

[1Day1Life4Now 882]

The insurance rep probably knows the policy better than your job HR person.

[elfnow 277]

If the insurance plan's rep said it's covered go with that. But for your own peace, call them again. Ask if they track their calls, do they document what you were told, is it covered, what's the rep's name, is this being documented (yes please do!) thank you very much bye.

Probably your employer has a stack of old info they gave you and the plan has changed since that paper was printed. However definitely double-check and get the rep's name and make sure the call is documented... If it comes to an appeal situation you can then say x rep told me on March 17 that it's covered, y rep told me on March 14 it's covered, etc.