Letter of Medical Necessity samples

trisher50
on 8/21/16 4:16 pm

My insurance policy with BC/BS says it does not cover bariatric surgery.  I am hoping, however, that I can write a letter of medical necessity.  Should I also have my PCP and my therapist write letters?  I've seen the sample letter on this site but thought I should ask for other samples anyway.  My therapist of three years can address that I no longer run to food for comfort.  I am praying hard for insurance to come through.  My BMI is 52.9. 

peachpie
on 8/21/16 4:56 pm - Philadelphia, PA
RNY on 04/28/15

Unfortunately, if your policy excludes Bariatric surgery coverage- a letter of medical necessity will do no good. It really comes down to the fact that your employer (or whomever) decided to specifically exclude this benefit. Kind of like how Catholic agencies can exclude coverage of birth control from its plans. 

Altenate insurance (if you have it), self pay or Mexico may be your other options. 

 

5'6.5" High weight:337 Lowest weight:193/31 BMI: Goal: 195-205/31-32 BMI

hollykim
on 8/21/16 5:52 pm - Nashville, TN
Revision on 03/18/15
On August 21, 2016 at 11:16 PM Pacific Time, trisher50 wrote:

My insurance policy with BC/BS says it does not cover bariatric surgery.  I am hoping, however, that I can write a letter of medical necessity.  Should I also have my PCP and my therapist write letters?  I've seen the sample letter on this site but thought I should ask for other samples anyway.  My therapist of three years can address that I no longer run to food for comfort.  I am praying hard for insurance to come through.  My BMI is 52.9. 

peach i.e. Is correct. If it is not a covered benefit, no amount of letters of medical necessity will make a difference. That is because your employer didn't buy the coverage for its employees so insurance will not pay to cover it. 

 


          

 

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