Insurance Exclusion

I have NHHP and they have an exclusion on any obesity treatment and I am now on my second level of appeal. They have been working with me and teaching me how to bypass the language of the policy to be able to have my surgery. I learned a couple of days ago that if I request a wls for obesity treatment I will be denied for sure BUT if I request pre-certification for gastric bypass surgery as for treatment of my Sleep Apnea or any other serios co-morbidity I will most likely be approved. They even told me that it's a language barrier and they are working with me to hopefully by pass it. I just wanted to share this little TRICK hoping that it may help someone in the future. Senator John Barnes of New Hampshire has been of an unbelievable help and I didn't even know him, emailed him and told my story. We have to keep trying! Good Luck!

I got approved after second level of appeal. So never give up because no doesn't always mean no

i know this is an old post but just wanted to ad to this incase anyone else is reading the old posts.... you can obtain precertification for anything because the board of dr's and nurses that are approving surgeries and other procedures are judging them purely on med nec and do not review your actual policy in most cases, the only time that precertification works is if it is needed to 'activate' an excisting benefit and just because you are precertified does not mean that it is a covered benefit and depending on you policy you could get precert have an expensive procedure and be stuck with the bill yourself you need prior approval they are two different things and they will look at your policy with prior aproval and sometimes when med nec aprove procedures that are not normally covered... i just didnt want anyone to get themselves into a rut with this because it happens.