Question:
Is this an iron clad exclusion? I have Human PPO..This is what it says

Any treatment including but not limited to surgical procedures for obesity, which includes morbid obesity for the purpose of treating a sickness or bodily injury caused by or complicated or exacerbated by the obesity..what are my chances of having them approve the revision that I need.    — tylerswife (posted on September 25, 2006)

September 25, 2006
oops I meant HUMANA PPO
   — tylerswife

September 25, 2006
Hi Rebecca! I have that insurance also. I don't know about the revisions but I can tell you that they did pay for my inital surgery last November. Now, I am trying to figure out if they pay for any "lifts" if i can figure that out I'll let you know also! Good luck to you!
   — KimY

September 25, 2006
Hi Rebecca! I have that insurance also. I don't know about the revisions but I can tell you that they did pay for my inital surgery last November. Now, I am trying to figure out if they pay for any "lifts" if i can figure that out I'll let you know also! Good luck to you!
   — KimY

September 25, 2006
HI I don't have that insurance but I can tell you that you should fight for it you have appeal right. You should have a 1st and 2nd level appeal right and more then likely extranl appeal right plus you can go to the department of insurance if they deny out your 1st and 2nd level appeal. Make sure you have your dr right a letter of medical nessaity. If you need more help on this let me know. I will help you in anyway that I can. I know alot about how the appeal process works.
   — Kjackson2

September 25, 2006
Hi Rebecca, Is this in the exclusions meaning not covered? If this is a true exclusion which means it is not covered, then no appeal can be done. I work for an insurance company and this has been my experience in the past. Check your benefits booklet and also contact your human resource person to make sure. If you like, you can email me if you have any other questions. God bless you on your journey. Never give up the fight.
   — camille1956

September 30, 2006
i agree with Camille C. also check to see if there are any state mandates that over ride the excludtion... then they have to pay and no apeal has to be done.
   — jackie B.

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