Question:
will this exclusion pay for wls

looking for a new insurance. if it says it excludes weight loss treatment and exogenous obesity will it pay for wls. please help!!    — [Anonymous] (posted on January 26, 2002)

January 26, 2002
Doesn't sound like it ~ but give them a call and ask. Sometimes they may still cover it even if it is excluded, just not quite as easily. Good Luck!
   — Laurie A.

January 26, 2002
Please, don't stop at a phone call. My policy had similar wording and when I called they said NO,flat out they would not pay. I went to my first appointment anyway and let the Dr take it from there. After months of playing the waiting game, they finally relented and paid for a good portion of my surgery.Good luck and don't be discouraged. Diane
   — Diane D.

January 27, 2002
yes, dont stop at a phone call,I called my insurence company last june, and they said no, my exclusion does say that it wont cover weightloss unless its obese, and she told me that ovese ws very big. I told her that I weighed about 230, and she said, no, thats not nearly heavy enough, obesisty is a wieght like you need to be lifted out of your tub with a crane, not my size. so, other then feeling really stupid, I left it alone. Untill Carnie Wilson had hers done, and then I looked into further, and found that obese is anything over 40 bmi, which is me. I could have have been alot further on our journey, then I am. I am still waiting for this to all happen, inusrence denied one, so I had to get all of my stuff in order, and its just been submittd again. So, we shall see. Yours sounds like it doesnt cover it, but please, dont quit trying, keep looking into other things, also. Good luck to you
   — amy T.

January 27, 2002
I'm not sure how you found out your insurance has this exclusion. I called my insurance company and asked them and they told me it wasn't covered. I said I wanted to see it in writing. She then sent me a page from the exclusions part of the policy. Lo and behold, it doesn't cover any weight loss treatment, EXCEPT surgery for morbidly obese. There are some conditions you have to meet, but for anyone who is morbidly obese, they aren't hard to do. NEVER take your insurance company's word for what they say on the phone. Always get it in writing. You should also be able to get a copy of the policy from your Human Resources department.
   — garw

January 27, 2002
First find some surgeons and attend their support group meetings. See and hear the surgeon and staff, do you WANT these folks to care for YOU? Once you get that out of the way ask about YOUR insurance company at the meeting. Fast easy educational way to answer your question. Picking a surgeon is like anything else.... SHOP AROUND! Of course personal referrals are really good, but do meet your perspective care giver, and ask lots of questions. I wouldnt pick a surgeon without doing this first.
   — bob-haller

January 27, 2002
Sometimes insurance companies write these exclusions about obesity surgery. I know mine has such an exclusion. But then they have an exclusion to the exclusion *sounds funny, I know* that states that they cover obesity surgery if you're MO. So, check it out.
   — tmrivas