does wording make a diff on exclusion

Hi all, Does anyone know if the way and exclusion is worded will make a difference of coverage. My exclusion reads" any treatment to reduce obesity including but not limited to surgical procedures." I wonder would they approve it since i fall into the morbid obesity category. Does anyone have any advice?

Why don't you e-mail Gary viscio at obesitylawyers.com and ask him his thoughts on this.I have heard that he has gotten some approved because of the wording in the exclusion.He will give you a fair evaluation of rather he thinks you have achance and if he can help you.His fee I think is pretty reasonable also.

Dear Melanie: When I started this journey in Feb. 2005, I had read profiles on this board that gave me a lot of hope in fighting an exclusion, especially if it is worded as poorly as mine is. (No mention of surgery, just services & treatment.) Unfortunately, your exclusion seems to be more air tight than mine. I have been continually denied and have sent complaints to the State of Illinois Dept. of Insurance along with the State's Attourney General and the CEO of the insurance company. I had also contacted Gary, but I didn't really get a straight answer from him about whether I had any kind of chance. He sent me the pricing of his services, but did not give me any idea which package to purchase or if he thought that he could do any more for me than I was already doing for myself. Although my insurance company AGREES that it is medically necessary, they just say that they do not have to cover it because I work for a small company and they do not offer coverage of bariatric surgery to small groups or individuals. They even went so far as to tell me to take my business elsewhere, our premium money means nothing to them. I have argued until I am blue in the face (and spirit) that the exclusion is poorly worded, and that I find it discriminatory that they will cover someone who works for a large comapny, but not a small employer, etc..... I got a reply from the Department of Insurance and they say: 1. The the response from my insurance company explaining that the poorly worded exclusion is STANDARD wording to exclude all "services" realting to obesity and morbid obesity, including medically necessary surgery is self explanitory! (Apparently, they did not even read my argument or precedent.) 2. That my insurance company has not broken any laws by not offering the same coverage to a small company that they offer to a large company and that I am S.O.O.L. (s**t out of luck), the state will do nothing to help me. I find this completely unfair, but the state does not seem to care. They do mention that I can continue to fight them by hiring a lawyer in private court, but I really can't afford it, especially if I have to now pay all my medical bills out-of-pocket. This kicker came in last night's mail with an EOB from Unicare stating that although they had approved and paid for my consultation with the surgeon last February, they have changed their mind and are taking their money back. I am not quite sure how they are going to get it back, but I guess that is a fight for another day. I do not really have the option to find another job, as I run the family-owned business for my father-in-law. I wish I had some better news or advice, but at this point, I am out of ideas. Maybe I will win the lottery so that I can pay for Gary. Thanks for listening, Dawn