Question:
Has anyone had recent problems getting approved due to Exlusions??

I've seen a few people on this site that have had problems getting approved due to exclusions in there insurance policy, but also noticed that most were a long time ago. Can anyone tell me if they have run in to any recent problems getting approved due to exclusions in your policy? Thanks in advance for your help!    — Michelle E. (posted on August 11, 2003)

August 11, 2003
Sorry i didn't have trouble, I was approved in 3 weeks with UHC, EPO.... But I do know of people who have had problems with exclusions and generally if they have an exclusion you can fight forever and they WON'T pay! Especially Premera Blue Cross, MSC....good luck to you!
   — Saxbyd

August 11, 2003
I had UHC HMO at the time of my surgery and had a specific exclusion that did not cover WLS or any treatment of obesity or morbid obesity. We had to appeal 2 or 3 times but eventually they did cover the RNY. Debbie
   — Debbie S.

August 11, 2003
In answer to insurance exclusions. After I learned that the insurance from my employer had an obesity exclusion, I also learned that it was my employer who had that written into their policy. It was another cost-saving measure. Luckily, my husbands insurance covered everything but $300 of the surgery. What a steal. There is nothing you can do about the exclusion except get another job and ask to review the insurance policy first. I was floored that the company who supposedly supported my surgery was the same one that had the exclusion. After I told them I planned on having the surgery - they fired me. I can't prove anything but I feel my life has changed for the better. I wish you luck in your journey. Meg Torrey
   — Meg T.

August 11, 2003
oh, yes, michelle! i have premera blue cross in washington state and have the iron clad exclusion that won't pay for treatment for weight loss, morbid obesity or any complications due to the condition. what a pity! i can abuse drugs and alchohol, and even abuse my kids, and they will pay up the nose to treat me, but they will let me die while paying for medical treatments and medications for all my co-morbs, high bp, sleep apnea, arthritis, diabetes, and they will pay for the rest of my life, when this one surgery would most likely solve all the problems. believe me, these ridiculous facts will be a big part of my appeal! good luck to you, i wish you the best! darci
   — darci T.