I just LOVE the insurance hassle....not!

[Guest guest]

Hi Everyone,

Just a quick question. Has anyone ever gotten approval for this

surgery even though it is specifically listed under general

exclusions in your policy? I have just under 3 weeks to go before a

surgery date of 1/27, which my husband's COBRA coverage was supposed

to cover. The insurance company is still giving me the runaround,

and then of course, January started, and now our out of pocket max

for the year is $6000 instead of $3000, so I have to pay an

additional $3000 for my surgery if it is even approved. (Out of

network surgeon (there are no in-network surgeons in my area), he's

only covered at 65%, and the hospital is at 85%) So....(are you all

following me here:-)?) my insurance plan through my employer starts

on Feb. 1st. It specifically excludes " Orthognathic reconstructive

surgery " . I spoke to the insurance agent, and he told me that

sometimes even excluded things get covered. He has offered to help

in any way possible. I just don't know whether to go through with

the surgery in January (if it even gets approved), or to save the

$6000 and wait until February to try.

Anyone have any suggestions, or experience with this?