Question:
If a policy exludes weight-loss surgery, how can I appeal?

My insurance company (Medical Mutual), covers Gastric By-pass if medically necessary, by but my employer's policy specifically excludes weight-loss surgery. Is there anyway around this through an appeal to the Ohio Dept of Insurance? Has anyone ever had any luck with this? Any suggestions? Any ideas? I want to do this so badly. In the long run, my employer and insurance company will save money...how do I get them to see this? Thanks for the help.    — Elissa H. (posted on April 25, 2001)

April 25, 2001
You must appeal to your employer! Write up your information and include statistical information on how much they will save in health care costs, etc...You might also include some ADA (American Disability Act). There should be some information under your state concerning discrimination based policies where companies will not pay for services to a specific group of people, i.e., an insurance company couldn't and wouldn't tell a cancer patient they couldn't receive services - it's the same thing! I appealed to my employer and they went outside the contract and have decided to pay for my surgery. It took a little time but I was successful. Good luck to you!
   — Sharon R.