Ben Naki

I am currently unemployed, but I have medical insurance coverage with HMAA . For six month have been fustrated because they don't want to covered my Gastric Bypass surgery. The argument seem to be that Gastric Bypass is weight loss program not a medical procedure. According to my medical benifit weightloss program are not covered by HMAA. Gastric Bypass surgery is not a weight loss program(Jenny Craig or Weigh****cher's) it is medical procedure. I don't see Gastric Bypass Surgeryas mere surgery resultingin weight loss but as a surgery that could save my life on the same lines that open heart savesthe lives of many patients with severe heart conditions. This surgery is not a weight loss program but a medical procedure. Jenny Craig is weight loss program. Also note that in your letter dated July 29 you pointedout in paragraph 5 that "gastric Bypass is not a weight loss program...In my planned HMAA site sectionXIX.g.14 as the reason for exclusion. The term "weight loss" is not taken alone but describes the type of "program"you not covering. Beside the surgery is treating all the other medical condition/diagnoses presented by Dr. Lin and Dr. Balfour. This is HMAA replied to my appeal. HMAA is not questioning the medical necessity of the procedure or denying that gastric bypass surgery is a medical procedure. The issue at hand is whetther or not the servicemeets HMAA's definition of a cover benifit. HMAA is saying any service related to weight loss is not covered. But that not what it say on my medical benifit coveraged. What i need is help or idea of what to do.