Is it common for ins to have an exclusion

[daco525 0]

Are there lots of policies that have exclusions? Is this the norm or rare? I have BCBS NJ Horizon/PPO/Direct Access. Right now we do not have an exclusion. My employer is moving all employees to Horizon in July, they will be eliminating the traditional plan. I am afraid that they may make some changes to our current Horizon plan, like an exclusion for weight loss surgery. I am wondering how many people have encountered exclusions on their plans. I will be ready to have everything submitted to ins May 1st. I am worried with changes around the corner that I might not get an approval in time.

[RestlessMonkey 7]

The "exclusion" isn't usually driven by the insurance company, but rather by the purchaser of the insurance, uour employer. In other words, in order to cut the cost of the insurance (and it is staggering) some companies exclude certain services (like psychiatric outpatient treatments, and weight loss surgeries, for two examples)

To know what your company may be planning, you need to ask your HR department.

[HeatherO 7]

Many employers exclude certain services in order to reduce health insurance costs. Sadly this is a very common occurrence. The person who is making the final decision on insurance coverage my be the only person who can really answer whether you will lose the coverage for WLS.