Question:
HAS ANYONE BEEN DENIED DUE TO AN EXCLUSION IN AN INSURANCE POLICY THROUGH BC/BSMST?

   — CARLA C. (posted on May 15, 2002)

May 15, 2002
i have benefit planers and they denied me beacuse there is an inclusion that says the wont pay for treatments for obesity wether medically necessary or not....so i guess i will be fat for ever or until i have a heart attack from being overweight.but i do wish you luck
   — leighrobi

May 15, 2002
I wouldn't give up without at least a fight. Your best chance of getting approved is going to depend upon the seriousness of your co-morbidities. Do you have sleep apnea, diabetes (type 2), high blood pressure or high cholesterol, Joint problems caused by weight. If so, then they cannot deny you treatement for those health problems, and if the best solution for theose problems would be WLS, you have still got a good chance. I would contact Walter Lindstrom at obesitylaw.com and get him working or your side. I hired him and got approved only 3 days after he sent in my appeal. This after fightying with the insurance for 4 months. Good Luck.
   — Dell H.

May 15, 2002
leigh, depending on the wording of that exclusion, you may have a case. Does it say it doesn't pay for any weight loss treatment for obesity or...for morbid obesity? There IS a difference and it's how I got around that road block with BCBS of CA. Just a thought...good luck
   — Barbara H.