Insurance Company Advise

danad · 02-26-2007, 03:23 PM

Attention everyone who wants the LAP-BAND^®. It has nothing to do with the insurance company on why they deny you of coverage. It has to do with your company, they have restriction if they cover it or not. Don't waste your time going to the doctor, just call the insurance company first and if they tell you they don't pay for it, then you know right then instead of going to the doctor and being disappointed. This is what happened to me and I have been with 4 different insurance companies, and I finally found out the truth. So call the insurance companies first. This is the best bet. It is your company not your insurance, so there is no use on fighting with them any more about it.Good Luck Everyone

**Alexandra** · 02-26-2007, 03:53 PM

Thanks for sharing your experience, but it just isn't safe to say that it's always the employer calling the shots. With small employer groups (such as, in NJ, those with fewer than 50 employees) the insurance carriers' standard policies may come into play. There may also be state mandates that even large employers are bound by.

Insurance regulations vary from state to state so it's ALWAYS a good idea to contact your state department of insurance (or health, whichever has jurisdiction in your state) and find out what your rights are. Don't make any assumptions or draw conclusions based on someone's experience in a different state.

Candle · 02-28-2007, 10:37 PM

Quote:

Originally Posted by Alexandra

With small employer groups (such as, in NJ, those with fewer than 50 employees) the insurance carriers' standard policies may come into play.

This is the reason for the exclusion on my plan (out of CT). Not my employer's "choice".

(I bet it’s an EMPLOYER exclusion in the majority of cases though)