Insurance question

To make a long story short my brother probably needs surgery as two of his doctors have suggested to him.  He has diabetes and an issue where he isn't digesting properly which is probably related to the diabetes.  This has been going on for about 9 months and there are no real answers yet.  He will get sick for days with severe stomach pain and vomiting and on two occations has been hospitalized for a week at a time. He called the insurance company and they said they don't cover it.  He pretty much took that and threw up his hands with an "oh well, I tried". I told him to go to a surgeon first to make sure he would qualify and they would do the insurance work anyway.  I'd love to help him anyway I can but it has to be his decison and he has to do the work.   Here is the question: Is that the end of the line or is an appeal in order?

He still might have a chance with the insurance if his health is in danger.

I figured that don't give up might be the correct answer.

Bariatric Surgery? Although as the recent 60-minutes episode showed, WLS does seem to be a “cure” for Diabetes, Insurance won’t cover it for that reason, Only for Obesity with Co-Morbidities. Does he have a BMI over 35? Then keep going for it.  Unless his insurance has a written exclusion, and even then some overcome exclusions in appeals If the cir****tances warrant it. Keep going for it would be my advice. Best Wishes- Dx

That 60 minutes episode is what opened his eyes, I think.  Thanks for the info!

Thanks a lot Paul.  As always, you are the man.  I will pass along the info.  I hope it helps.  Thanks again.