Need info on anyone who was approved by a federal insurance plan for my appeal :-)

I've been denied twice by my federal HMO. Per their contract WLS is covered, but the HMO gets to decide what the medical necessity is. They are not following the federal guidelines, nor what other federal insurance companies are using for WLS criteria. My BMI is 47.8, high cholestrol (high LDL), back pain, knee pain, fatigue, shortness of breath, insomina,gallbladder already removed, small leak in heart valve, apple shaped, depression, low self-esteem, limited physical activity (obesity), possible thryoid problem, etc.... If you had WLS that was approved and paid for by a federal insurance company. Please e-mail me your name, insurance company, their criteria for WLS, date of your surgery, type of surgery, how long it took you to be approved. Plus anything else you feel will help me to achieve approval from my HMO. Thank you to Ray Hooks for suggesting that I show in my appeal that other federal insurance companies are approving WLS using the federal guidelines. Maurine

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.