Beth, I know how difficult it can be fighting insurance companies--a horrid roller coaster ride. Hang in there, hun. Your BMI should qualify you for the surgery. I don't think it should be legal for an insurance company to determine what is considered medical necessity...that's why we have physcians. I obtained the services of an attorney during my very last appeal. He has helped out quite a few OH members. His name is Gary Viscio. He's fees are reasonable, and he is very responsive to your questions/emails, etc. So far, he has been 100% on his appeals. You can learn more about him from his website at obesitylawyers.com. I just won my battle with the insurance company last month, and I'm scheduled for surgery on September 16...please, don't give up! Your tennacity will pay off! Your health and well being are too important! You are in my prayers. Bama Gal