Question:
Is exclusion of obesity surgery in my Humana PPO policy the final word?

I just got back from my appointment with Neweigh. After driving over 500 miles roundtrip, I am very down. I was told on the phone by Neweigh that after talking with Humana, WLS is not excluded in cases of medical necessity. After driving there and sitting in the waiting room for over an hour, the intake worker told me in less than 5 minutes that WLS is an exclusion with my policy. Is there any hope? I have Humana PPO. I called the precertification nurse myself and she told me that it is a covered benefit if it is medically necessary. But, in my coverage booklet it is excluded. Why am I getting the run around? What are my options? Neweigh was no help at all.    — Brenda B. (posted on October 14, 1999)

October 15, 1999
Brenda, Sorry I was kicked off the computer. I went to Neweigh, had my surgery in Feb. of 99. I can't say enough good about them, they were very helpful.We did start the procerdure of getting a ok, in Nov. of 98, it took that long to prove to the ins. it was a medical need. They finially saw the light.I have never felt this great. 80lbs. less:)Do'nt give up.There is help out there.Denise Belangia ([email protected])
   — Denise B.