Well,Insurance says I dont have the rider on my policy

[jennypoo 0]

Call the insurrance company yesterday to see what they had to say before I even went the the lap band doc.I have Optima health and its thru work.Well when I called them they told me I dont have the morbit

obesity rider on my policy!! So does that mean I dont have a chance on them paying for it?If anybody out there can give me any advise.Do I stop here or go ahead with the plan to see the doctor?I currently have a bmi of 43 with high bp.

Thanks Jennifer

[Alexandra 55]

I would ask for clarification on that statement, Jennifer. Does not having the rider mean it's covered? Or not covered? That depends on what the standard contract says and what the rider itself says. (A "rider" is just an addition to the contract. It can either add benefits or take them away, depending on what it says.)

So ask in plain language what your benefit is for the treatment of morbid obesity. Find out what your rights are in your state with regard to health-carrier decisions--can you appeal?

Don't give up based on what one person at your insurer said. They might or might not know precisely what they're talking about.

[faithmd 14]

Check out this thread:

http://www.lapbandtalk.com/f8/new-cpt-codes-lap-band-11845/

Write down the codes and ask them if those specific codes are covered.