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Ok People I need some help and pray someone out there can help me. Two weeks ago

I got insurance approval via telephone, yesterday I finally got my letter and

they have only approved me for 50% up to $4000.00. My letter came with a copy of

a new addendum to our policy stating that is the max. dollar limit on WLS.

Has anyone had this problem? Did you or can you appeal something like this? I

need help, I am totally lost when it comes to dealing with insurance (I believe

if insurance is not the antichrist, they should be).haha

If I cannot change their minds, I cannot have this surgery (or any WLS) I have a

$2000 deductible and then my 20% is wiping us out as it is.

What is really confusing me is that the letter says they will only pay 50% up to

$4000, but Dr R is in network for me as is Durham Regional and my policy says in

network is 80/20. How can they only pay 50% if he is in network? I have called

and talked to 4 different people and each of them have given me a different

story. One lady even told me that I was actually paying 70%.

Where do I go and what do I do? Helpppppp !

Gwen

Still waiting !!!!

.........................................................

iWon.com http://www.iwon.com why wouldn't you?

.........................................................

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