Question:
I have been denied on the basis of an exclsion. Has anyone been approved?

What is the process to take to get appoved? I have Mercy PHN HMO.    — Justina M. (posted on December 29, 2003)

December 29, 2003
Hi Justina, I had an exclusion on both of my insurance companies, and hired Walter Lindstrom to help me. Walter was great - he was very up front and told me that it was useless to fight my particular coverage - I was better off saving my pennies and self-paying for my surgery. I have great respect for him for being so straightforward. Check out www.obesitylaw.com and www.obesitylawer.com - both are great resources. If you find that insurance isn't going to pull through for you, then perhaps you're willing to consider self-paying. It cuts out so much red tape and rigamarole - at least it did for me. You can see www.bodybybaltasar.com if you'd like to know more about the option that I opted for. Blessings, dina
   — Dina McBride

December 29, 2003
Exclusions are nearly impossible to win. A VERY few people have overturned them but most are iron-clad. Sorry. The advise to contact Walter Linstrom is good. At least then you would know if you even have half a chance. Good luck.
   — Delores S.

December 30, 2003
hi justina - i myself had an exclusion and tried to get approval anyway . did not happen , they will not budge . i had humana ppo , so i waited afew months and when our renewal period came up , chose a different policy . we do get to choose from a high ppo , low ppo , or hmo . the hmo covered the surgery , so we switched to that type . it will be covered completely , minus a co-pay to the surgeon and the first one hundred dollars a day to the hospital . i can swing that amount . so maybe , if there is a chance of choosing another type of policy when this one is up , try that . i doubt with even help that you will get approval with this exclusion . i was at this spot in asking all these questions too , just hoping and praying ....... good luck !!!!!!!
   — patti G.

January 1, 2004
I too had an exclusion, I contacted Walter Lindstrom, and he also told me that my exclusion could not be broken. He was very honest, you might contact him and see what he says about your exclusion....in the end, I self-paid and went to Mexico in 8/03...so far am down 80 pounds. Good luck to you!!!!!!!
   — jennap