Question:
Do you think I'll be approved?

This is how my policy exclusion reads: Care and treatment of obesity, weight loss or dietary control, surgical or otherwise, or any complications, or nutirional counseling for weight loss or control whether or not it is, in any case , a part of the treatment plan for another Illness. Medically Necessary and Appropriate charges for Morbid Obesity will be covered; non-medical charges for weight loss or dietary control including but not limited to nutritional counseling are not covered. My BMI is 57 and I have sleep apnea, high blood pressure and CHF.    — [Anonymous] (posted on January 31, 2000)


January 31, 2000
You may have to change your reasons for having the surgery. I have BCBS of LA with an exclusion similar to yours. I am hoping my surgeon can intervene on my behalf. He is going to do the surgery to correct another problem, and it is really not related to obesity. I hope. I am praying that they will approve.
   — Nancy B.

January 31, 2000
Sounds great to me wish all insurance read like this. Have your PCP now write the necessary medical necessity letter listing your co-mortalities.. By the way who is your insurance carrier? Share with those looking for insurance that cover WLS. Victoria-Open RNY 12/8/99 (59 lbs gone as of 1/27/00) http://www.angelfire.com/ok3/vbowen/index.html
   — Victoria B.

January 31, 2000
Oops this was all I read..Medically Necessary and Appropriate charges for Morbid Obesity will be covered. I was doing three things at once and did not read it all.. I still think however that a good well worded letter from your PCP and Surgeon may do it.. Good Luck..
   — Victoria B.

January 31, 2000
It sounds like surgery for morbid obesity is covered if medically necessary, and you certainly have co-morbid conditions. You didn't say which company you have. That will probably be the most important thing, as some insurances are approving easily and some are not.
   — Cathy S.




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