Is it POINTLESS to fight an exclusion?

[Guest BikiniBeachy]

My previous insurance, Kaiser, had a secret 'exclusion' that the sales person LIED about when I bought my individual insurance a few months back and specifically ASKED about bariatric surgery, so naturally, when my paperwork came back that was my reason for denial.

Some people have told me not to waste my time, how could I fight it when something as simple as "We told her, her insurance doesn't carry that surgery!" OR SHOULD I?

HAVE ANY OF YOU ever fought this and won?

It's so silly, I can't believe they can treat it like it's something cosmetic...

[MacMadame 81]

I think you're screwed. If it was your company's exclusion, you could appeal to the company to get them to pay for it, but if it's private insurance, there is no one to appeal to.

[Joy1234 0]

That's the word I was looking for!!! Thank you...my husband's company has an exclusion...no WLS. So my question now is, has anyone had any luck petitioning a company...I think you call it a waiver, and or something else...

Thanks, Joy

[Joy1234 0]

I was chatting and asked the infamous (as of tonight for me :biggrin: exclusion question, and one person said it was almost impossible for one to try to get a waiver from that company...so I may be paying out of pocket...I need to check to see if my insurance will pay afterwards if something happens and I need more medical intervention.

goodnight

[GinaJ 2]

Go to www.ObesityLaw.com and see what they say under FAQ. Hope that helps.

[Joy1234 0]

Thank you! I checked and I think I won't fight...and now I know I need to check with our insurance to see if they will pay if I have complications (I would have already paid in cash obviously)...thanks for your help.