case for appeal

tina19
on 12/2/06 5:08 am
I was denied last week for wls. exclusion in policy  for any kind of obesity surgery. In researching different policies humana offers thru my husbands work i noticed different wordings in the exclusions for wls. some said only obesity while others stated morbidally obese. my exclusion no surgery for treatment of obesity. I am Morbitally obese BMI 41. My policy also includes a definition for morbitaly obese. Has anyone appealed based on this reason.
(deactivated member)
on 12/8/06 9:36 am
if wls is excluded from the policy wether it actually says obese or mobidly obese really doesnt matter if there are different policies offered and one states that 'programs' to treat obesity are not included but says nothing about weightloss surgery and the only other choice says definately no surgery is covered i would go with the first if that helps at all that really is the only time that i coud see you getting around this but also... you should definately apeal alot of times apeals do actually work... not sure if this is very much help but i saw that no one had responded so i thought i would try as best i could. good luck and dont give up!
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