Exclusion

Does having an exclusion on your medical policy does that mean that you can not get weight loss surgery at all? Or does it mean that it has to be medically necessary

An exclusion to your medical policy means it is not covered even if it is medically necessary. What your insurance policy covers is governed by what your employer will cover. Most insurance companies require an "obesity rider" and if your employer does not want that covered then they will not pay for the rider. Unfortunately I have been in the situation where in the process of my qualifying for surgery my employer changed thier policy and dropped thier rider that covers the surgery.

I have an exclusion on my policy that excludes WLS yet on the 1st I'm having it done and insurance is paying....

For a year I was told to give it up, the insurance would never pay, well I should have called the insurance myself!

My insurance BCBS of TX PPO does cover WLS period. They did not cover it for "Morbid Obesity".
They said "yes" to my RNY Gastric Bypass after my surgeons office sent it in that is was for my Diabetes.

And now my surgery is 5 days away!

You might consider going to a different surgeon, one who's office really knows how to go head to head with insurance companies.

Hope this helps!!