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I got Denied by my insurance Beech Street.

Has anyone done their surgery through insurance with Beech Street. I got denied for coverage through the surgery but I wanted to know if anyone got denied and appealed or wrote a letter. Please help me I need info. My BMI is 44.41 and I have no comorbidities. But I am 19 and trying to catch it early.:thumbup:

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What did your letter of denial say?

If it is because you have a weight loss exclusion in your policy then they will not cover it.

But it could also be that you haven't sent in everything they require of you. Your doctor's office may not have sent in all the information they need.

  • Author

the doctors office just talked to them. They came back in the room and told me that there was an exclusion so i am not covered. I never eprsonally talked to them. I never got a denial letter it was just an over the phone thing. Should I just call them myself and ask what the exclusion is?

the doctors office just talked to them. They came back in the room and told me that there was an exclusion so i am not covered. I never eprsonally talked to them. I never got a denial letter it was just an over the phone thing. Should I just call them myself and ask what the exclusion is?

Yes, you should call them and have them send you the policy information on weight loss surgery.

Brenda,

Typically, if there is an exclusion on the policy, they do not cover weight loss surgery for any reason. I'd call and make sure that is what they mean when they said there is an exclusion. Good luck.

What insurance do you have

  • Author

beechstreet ppo through my fathers work.

Hi Bren, Is your father a union electrician? My husband is and his insurance is also beech street, read the summary of benefits a little bit ago and there is definatley a wls exclusion, but I haven't and won't give up, there was some info in there that gave me hope...i would like to know though if there is anyone out there that has been approved by Scott & White or Texas Tru Choice???

  • Author

I don't believe he is. He is an electrician though. I think that I am just going to work on getting my credit score up right now its at a 569 and then I can apply for credit through Care Credit or Capital One Health. I really want this surgery and I won;t let insurance issues stand in the way. I would also rather not go through all the hoops of getting insurance problems figured out becuase if I keep waiting for that I would probably have gained 50 lbs from all the stress and eating that comes with it. I have found a place here in Tx hat does it for around $9000. TLCEdge and have heard good things from others and the people themselves so Hopefully by the middle of this year or end of it I will be banded. Wish me Luck:thumbup:

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