bcbs of GA covers lapband but employer doesnt

[peachylady 0]

How do you get an exclusion off the insurance. My son talked to the HR and she seems to think it is not a big deal. Does this have to be changed at the renewal time or can it be done anytime. Does my DIL need to submit something in writing to them of necessity? Any information on this would be greatly appreciated.

thnaks

[jknsk2002 0]

I don't know , I am having the same problems with Aetna. Aetna PPO coveres it , but our plan doesn't because it is "Small Business" and it's not a covered benefit" if it's small business. I can't even go and try to get denied. They just won't accept anything from the doctors. LOL. Its a joke. Let me know if you find a loop hole. Good luck to you !

[peachylady 0]

This is for my Daughter in Law. It is my son's insurance. I hope you get a way around it..Have you talked to the HR person at the business to see what you can do if anything. I am just praying that when they get the one for next year it will be covered.

I had lapband on June 5 of this year and am so happy with it. I have lost 54 pounds and almost half way to goal.

[Kissmygrits 0]

I'm not a benefits expert, but the way I understand it is there is no way around it unless you can convince your employer to take it off of the list of exclusions for the next plan year. Employers may or may not be willing to reconsider as it generally cheaper for them to purchase the coverage for employees if they exclude certain procedures.

You may want to speak to the HR or benefits director at your company before the open enrollment period-- this is when those exclusions, etc. are negotiated with the insurance companies.

[peachylady 0]

Thanks that is what I am thinking is going to have to be done.