aramey75

Its 15 months because they changed policies mid year. Our open enrollment was in August for October, 2012 - December, 2013 so they didn't have to do another round of open enrollment after just 3 months and they can get it back to the calendar year cycle starting January, 2014. I really do understand the mechanics behind the rider system. I really do. I just wasn't sure if there was anyone out there who was able to appeal to their employers and actually win. What irks me is that Medicaid covers it. I pay for that through taxes. However, my husband works for a government agency. So essentially, they'll cover it through Medicaid but not for their employees. (He is local government, not state).

I am so utterly rejected. I was mid-process a few years ago when I had to change employers due to family reasons. We had to change our insurance to my husband's provider that did not cover WLS. Imagine my excitement when we got notification that they were changing providers to BCBS (VA) - which I knew covered WLS. So, I started over again. Went to the information session. Made the appointment with my surgeon for next week. Got the insurance cards in the mail over the weekend. Called the provider, and confirmed that the employer does in fact carry the rider. An hour later, had to call back for another question. Spoke with a different person. They saw something different. So, after an hour on the phone, emails flying between BCBS and the plan administrator for the employer, and my husband and HR. It is not covered. So - my question is this. Is there anyone here who has fought this with their EMPLOYER? And won? What can I do? Anything? The worst part about it is, we tied ourselves for the next 15 months to the highest plan his employer offered because of the hospitalization benefits. We wouldn't have gone with it, otherwise. Thanks in advance for your help!