Question:
Denied for tummy tuck...how should I appeal?

My insurance has a $30,000 limitation for the "surgical treatment of morbid obisity, and complications of such surgery" So, I easily reached my lifetime maximum once I had WLS. I am now trying to get a tummy tuck. I recieved my letter in responce to my tummy tuck request. The insurance co., basically said that the tummy tuck procedure would have been covered, however, since I reached my lifetime maximum benefit, I was denied. I really don't agree that the TT is complication of WLS or surgical treatment of being morbidily obese. I am no longer morbidly obese. My doctor;s office said I should try to appeal, but they have sent in all the documentations they can. Does anyone have any ideas of what I could put into my letter? Or does most agree with the insurance company? Any insight would be helpful. Thanks!    — Karen A. (posted on February 11, 2002)

February 11, 2002
Sooooo, what if you had lost the weight via dieting? Then sure, they'd not have paid for it, but would it be considered related to "treatment" for obesity? Or just reconstructive surgery, similar to breast reduction? Just a random thought......
   — vitalady