Is this exclusion language?

Or is there a work around? Please see the policy language below. I have Humana POS.

"Any treatment, including but not limited to surgical procedures:
- For obesity, whi*****ludes morbid obesity; or
- For obesity, whi*****ludes morbid obesity, for the purpose of treating a sickness or bodily injury caused by, complicated by, or exacerbated by the obesity."


We have insurnace renewals upcoming and I have some say in who we choose (but we only cover 3-4 employees). So in theory we could switch to another provider.  If this IS an eclusion any idea how much it would cost to add bariatric coverage?

ETA:

As it turns out the surgeons practice is an in network provider (he only does bariatrics) although I could not find him individually.

Ann

It reads like a clear exclusion to me.  I don't think there would be any work arounds because it's pretty much saying they're not paying for WLS under any cir****tances.

I agree, those statements clearly state services related to obesity or mobid obesity are not covered. 

I don't know much about obtaining coverage just check your options and work with your agent to get the best policy possible. :)

Good Luck!

Thanks for the advice. I spoke with my agent and its curious to note treatment for MO is required in my state. We are still going to check the policy though. I called and gave them the CPT codes and they said they required medical neccesity but could not tell me if they were an excluded service. I guess we will just have to file and see. Otherwise I will explore my self pay options.