Question:
PLEASE help me to understand the exclusion in my coverage

My insurer is Healthcare Oklahoma(HMO) the excluson says: Weight loss programs, except as provided in a Healthcare Oklahoma approved wellness program. Obesity surgery, gastric stapling, and gastric balloon, unless authorized by your PCP and a Healthcare Oklahoma Medical Director.    — Lynda T. (posted on June 6, 2001)

June 5, 2001
Believe it or not, they cover it. But, you must follow the correct process. Go to your PCP first, and get a referral. This will begin the process. Once you have that referral, I would call your insurance rep and ask for the requirements for approval of surgery. Tell them you have a referral and support of your PCP. Good luck!
   — [Anonymous]

June 6, 2001
I have United Healthcare, and under exclusions it says gastric stapling for weight loss is not covered. Once the nurse at UHC got enough information to realize that gastric stapling and gastric bypass were not the same procedure, she approved it. Hope this helps.
   — Mary D.