Exclusion Question

This is what my insurance booklet says..

Regardless of Medical Necessity Benefits are not available for any of the following ... obesity or morbid obesity.


Okay I want to know is there anyway around this? Can we say the surgery is to treat my arthritis, GERD, depression, or back and knee pains rather than for obesity?

 Sounds like your exclusion is pretty iron clad. If your insurance is self funded you could try appealing directly to your employer. If your plan is self funded then your employer has the ultimate last say. If your insurance is fully funded then I don't think you have a chance of getting coverage. Have you considered getting a part time job? I've heard that places like Home Depot and Starbucks offers insurance that covers WLS to part-time employees. Best of luck to you.

Unfortunetly a part time job is out of the question for me, I have a 2 month old baby and my husbands job has him on 24 hour call so I would not be able to have him watch the kids. Im going to have to start saving for self pay on this one, our credit is bad so financing it is also out of the question. :( This is going to take a while LOL.

they cants do wls with a dx of arthritis gerds and etc. it has to be dx of obesity.  Is your insurance a fully insured or self funded policy through your employer that could make a would of difference on fighting an exclusion.  Need moe informaiton PM me or my email is on my profile