Question:
can i fight exclusion /weight reduction programs; surgical treatmnt of obesity loss

i have exclusion in ins policy booklet..reads as following weight reduction programs;surgical treatment of obesity loss. i am morbid obese weight 375 female. who works for a hospital..2 years ago employee's were treated and paid. the human resource director told me those people slipped thru the crack on getting there surgeries paid. please help !!!!!!!!    — AMY Q. (posted on January 15, 2003)

January 15, 2003
Amy.. Yes you can appeal that I work in insurance and they mostly state that they don't cover it for the treatment of obesity because they ONLY cover it if medically necessary usually only for the treatment of morbid obesity, if it does not say morbid then you can still put in for approval,and if deemed medically necessary they will probably cover it. Good luck
   — lisar02169

January 15, 2003
My policy says it is not covered for obesity, but I had ulcers in the esophagus and this was the only treatment left. BCBS covered it, but every time the obesity code is put into their system it is rejected and someone has to manually over-ride the system to make it work. So, the big trick is getting to the right people so your bills are actually paid. In my case they paid for the surgery but turned down the anesthesia! LOL yea, I can have surgery but no anesthesia? Oh well, it is just a continual battle but well worth it.
   — Thomas M.