Question:
Has anyone has a successful appeal when employer has exclusion?

I have many co-morbidities including spinal stenosis, hyper tension, sleep apnea, foot pain , severe arthritis of the right knee two previous hip replacement , depression, shortness of breath, and vascular insufficiency. Any hope?    — collinsnatalear (posted on April 25, 2006)

April 25, 2006
My husband's employer had an exclusion but I submitted the paperwork anyway and it was approved! I didn't have many co-morbids either.. borderline diabetes, sleep apnea and normal/high blood pressure. I'm post op now and they're paying for 90% so I won't argue with them! Good luck!
   — Lauren003

April 25, 2006
Another angle is to do your research with the help of your doctor about what these comorbidities will end up costing the insurance company in the long run- The insurance company works in $ and decimal points so work their own angle- is it cheaper to pay for the surgery now or long ter hypertension, diabetes, cholesterol and possible other ccomplications- be factual and not emotional- sell yourself and the reason you need this surgery will not only benefit you but them financially.
   — dabby

April 25, 2006
I was originally denied due to an exclusion by my employer. My surgeon (who I think carries more weight than an individual ... pun intended) appealed, and I don't know what transpired between the doc/my company/insurance, but I was approved. Don't give up ... there IS hope ... good luck.
   — Karyn B

April 26, 2006
My insurance said it didn't cover obesity surgery, then later down the booklet, it said it would if it was medically necessary. Check your booklet well.
   — geneswife