Question:
Is there any way to get around a written exclusion policy?

I work for the City of Fort Worth and we just changed over to Aetna PPO. We have always had a written exclusion policy ref weight loss surgery. I have sleep apnea, diabetes, and hyptertension so I think it could be proven that it is medically necessary. Is there anyone out there who has been able to get past a written exclusion policy? If so how, please let me know. There is no way I can afford it on my own. Thanks.    — Donna W. (posted on April 17, 2005)

April 17, 2005
Hi Neighbor - I am in Grand Prairie. I had UHC which is one of the better companies, but it did have an exclusion for treatment for obesity. However, the key was it being turned in as Morbid Obesity. If the doctors would have submitted it as obesity, it would have been turned down. I also have diabetes, hypertension, heart disease, etc etc. and mine went through easily. I didn't even have to do anything. The doctor submitted a letter based on morbid obesity and my co-morbidities and it went through with no other requirements. Just be sure they specify "morbid" obesity. Good Luck Donna. I had my surgery last August and just hit my 100 pound milestone. It has changed my life completely.
   — dwhit54

April 18, 2005
Please read my profile about my journey and successful surgery, I'm now four months post-op. Also included is information about how obesitylaw.com helped me. Any questions, please email me. (RNY LAP 12/17/04)
   — jenniferw