This is what my policy says about wls...is it a lost cause??

My policy is pretty vague. Out of 51 exclusions & limitations, this was number 49 and it is worded just like this..."any gastric and/or other intestinal surgical procedure for the purpose of treating obesity is not covered." Okay guys, give me some hope here. It doesn't say "morbid obesity"...and I have numerous health problems specifically related to my weight, PLUS I have a wonderful, two page letter from my pcp saying its MEDICALLY NECESSARY and I should not wait any longer than necessary to have my VBG done. (Is the VBG considered an "intestinal" procedure??) It also states that "no items under the exclusions and limitations list shall be covered unless it is "reasonable and necessary for the diagnosis or treatment of an illness or to improve functioning of a malformed body member or for maintenance of the health of a member." If anybody has a malformed body, its ME :o) Anyone wishing to decipher this mumbo-jumbo for me and speaketh to me in English?? Thanx! :-)

We greatly appreciate your interest in helping us build our Q&A database. To discourage vandals from posting garbage, however, we require people to register before posting.

You must be logged in to post an answer. Click here to log in.