What does this exclusion mean???

KimmySport
on 4/11/07 8:30 am - LA
Are incurred for cosmetic or aesthetic reasons, such as weight modification or surgical treatment of obesity. I am shopping around for health insurance that will cover the bypass or lapband, and came across this policy. Since it only says for cosmetic or beautification purposes.. does that mean that it will cover surgeries that are medically nessasary?!! I am starting to get my hopes up.. I feel pretty hopeless right now.. Thanks!
Cindy C.
on 4/11/07 8:44 am - Norristown, PA
Most insurances will tell you it will be covered only if it is medically necessary, if you have not picked a insurance carrier yet either call your surgeon and talk to the person in charge of insurance may be they can point you in the right direction. If not Look to the left side of this page and click on insurance by state that might give you a little insight. Good luck!

Cindy Crispo

KimmySport
on 4/11/07 9:29 am, edited 4/11/07 10:15 am - LA
Thank you, Cindy! I will look  there-  I just talked to the insurance company, and they said that they DID cover the gastric bypass if medically necessary- BUT they did say that they denied a lot of the claims. So what is the next step? Do I buy a policy and retain a lawyer if they deny me? **Edited because I found the answer! Thanks!**
gggkm
on 4/11/07 10:50 am - philadelphia, PA
Cindy,         I am in the same boat. Looking into a plan that will cover the surgery. The only thing it said when I looked into policies is that you must not have had treatment in the past 12 mths for this. SO I cancelled my initial consult with the surgeon until I figure out which plan covers this also. Let me know what you find out.                                                  Kathy
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