Question:
Does anyone have any sucess getting approved, with Humana HMO, w/an exclusion policy

My Doctor submitted, for me to recieve the surgery, based on my BMI and my co-morbidities, I was denied because of their exclusion policy. I was wondering if anyone has any info that might help me in my appeal. I live in Wisconsin, and the State of Wisconsin is my employer. Any info is appriciated.    — pvwiscon (posted on September 26, 2002)

September 25, 2002
Welcome to the club;-) I'm also in Wisconsin and I have Humana HMO. My mom was just approved for the VBG, but she didn't want that so she's re-applying for the RNY. We have a pretty nasty exclusion (I have a copy of it in my profile under insurance), but it seems as long as it is medically necessary they might approve. (I'm in college and still under my parents insurance.) I'm waiting for approval right now. FYI, we were told ABSOLUTELY not for the adjustable-band (lap-band).
   — Toni C.