Author Topic: Insurance Denied Gold Eyelid Weight Surgery  (Read 2307 times)

Lance

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Insurance Denied Gold Eyelid Weight Surgery
« on: February 11, 2014, 05:26:40 pm »
I had the gold eyelid weight at 1.2 grams put in 3 years ago. The weight is now causing ptosis and I would like a .8 platinum thin profile. However, insurance just denied the change classifying it as cosmetic. Anyone ever deal with this or have recommendations for the appeal process? Thanks.

arizonajack

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Re: Insurance Denied Gold Eyelid Weight Surgery
« Reply #1 on: February 11, 2014, 09:56:02 pm »
I retired after 35 years in the insurance industry. All I can suggest is that you read your coverage very, very carefully with regard to the appeal process and make sure that your doctors understand what needs to be submitted to convince the insurance company that it's a medical necessity.

I can't tell you what that needs to be but watch this space as other might have been through a similar process and have some tips for you.

3/15/18 12mm x 6mm x5mm
9/21/16 12mm x 7mm x 5mm
3/23/15 12mm x 5.5mm x 4mm
3/13/14 12mm x 6mm x 4mm
8/1/13 14mm x 5mm x 4mm (Expected)
1/22/13 12mm x 3mm (Gamma Knife)
10/10/12 11mm x 4mm x 5mm
4/4/12 9mm x 4mm x 3mm (Diagnosis)

My story at: http://www.anausa.org/smf/index.php?topic=18287.0

 


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