With an exclusion to the policy, can I get appeal & get approved for back problems?

I have a BMI of 49, years of documentation on back problems, asthma, cholesterol issues, etc.However, I have been denied and I am trying to get approval on an exlusion to the policy(secondary insurance). Regence is my primary(no hope there). I need to prove a medical necessity. I need to write an appeal letter, Please Help!!

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