Question:
General exclusion and its wording

Has anyone been denied thier wls with a bmi of 40 or more, when thier insurence exclusions states, " exclusions are treatment, services, and supplies in connection with obesity, weight reduction or dietectic control, except for morbid obesity or disease etiology? Doesn't this mean that if your morbidly obese that youre covered, period? I am waiting for approval,,,,any help would be great    — [Anonymous] (posted on January 10, 2002)

January 10, 2002
Hi, My husband's policy had an exlusion that was worded "treatment for obesity and weight loss conditions is not covered". I wrote an appeal letter when I was denied after my initial consultation (BMI of 57 w/some comorbs). I was then approved because it was considered medically necessary. If you would like a copy of the letter that I sent, e-mail at [email protected]. Good luck!
   — Kathleen M.

January 11, 2002
My ins book said basically the same thing about covering anything for "obesity" but made the clear distinction about treating morbid obesity and medical necessity. I sent mine in with a BMI of 50 and was approved in three days!
   — ChristiMNB