Sleep Apnea Treatment

Question by Susana Sky: My health insurance company just rescinded my policy after I submitted claims.?
I applied for an individual health policy and in good faith signed that the information was complete to the best of my knowledge. I also consented to them acquiring any records necessary from my providers. I then had an emergency heart event that resulted in $ 20k+ claims. I then cancelled the policy after 5 months since I qualified for insurance through my employer. I just got a letter notifying me that I did not fully disclose all of my health history for the last 10 years on my application, therefore they are rescinding my policy as if it were never in effect. I am now facing $ 20k+ in bills and I am going to start the appeal process. How should I respond to the specific items they claim I did not disclose? One of them, for instance, is sleep apnea, which I was never diagnosed with and never received treatment for, but participated in a sleep study to see if I had it.

Best answer:

Answer by src50
Ask for the specific information that they claim you failed to disclosure along with it’s source.

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Question by kehlygirl: Insurance company denied weight loss surgery. Has anyone had this happen and then later approved?
Just asked primary physician for referrel and got denial letter a week later saying that I don’t have severe enough cardiopulmonary disease, diabetes or sleep apnea. That my current high blood pressure and hypo-thyroidism are being managed well with medication.

Best answer:

Answer by POPO
I have not had this happen to me, but I know a few people who have had the surgery. Whether your insurance company grants you permission to go ahead with surgery, you have to meet their criteria. You need to know exactly what their criteria is, and then speak with your general physician who will try to help you or counsel you against surgery if they don’t think it is reasonable for you at this time.

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Question by Dianna B: How do I get insurance for lap band or bypass surgery if my insurance company has turned me down.?
My insurance company will not cover lap band surgery for me (or gastric bypass for that matter). I have been overweight for years, have sleep apnea, sore knees, and the necessary BMI to qualify. Even the hospital that would do the surgery has told me that they turned them down. Paying for it myself would be out of the question. My company has been using this insurance company for years and years – I do not see them switching carriers in the near future. Is there any way I can get this surgery done? I feel the pros far outweigh the cons.

Best answer:

Answer by Lea B
Many insurance policies will not cover that procedure because it is not medically necessary. They consider it the same as cosmetic surgery. You can contact other insurance companies and ask them.

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Company is saying it was for other reasons, which were not true.

When I sent in my application for my health insurance, I forgot to note that I have obstructive sleep apnea. Stupid mistake, but I hadn’t had insurance since I was 20 years old and paid of my OSA treatments out of pocket nearly two years ago. I had an expensive hospital bill in September for a completely unrelated illness. When my insurer pulled my medical history, they saw the OSA and sent a letter with reimbursement for premiums and said that my coverage was null and void. I feel that they should cover the bill since the illness was unrelated.