Question:
What can be done if your employers policy says WLS NOT COVERED?

I have Medical Mutual SuperMed Plus and when I received my packet from them it states "WLS and complications from WLS NOT COVERED". I wanted to know if anyone knows what I can do? how do I go about asking my employer for a rider that would cover this proceedure and what is required for them to do this? Does it cost them the cost of my surgery? or does it increase their premiums for the entire company? I work for a smaller company (140 employees) and didn't know how this works, but someone suggested that I request my company to give me a rider for this surgery. Has anyone ever done this before and been successful? does anyone have any tips or advice? In order to do this would they have to change the policy for the entire company or would it be a one time thing that they would do for an individual employee? I'm just looking for some advice because I really don't know where to start, but someone on this site said that it can be done if I go through the right proceedure. Are there other ways of getting around this exclusion,(other than self pay)or is asking my employer for a rider the only option? I've looked for answers on the Q&A board, but didn't really find anything that fit with what I am asking about. Any help and or advice is greatly appreciated! Thanks!    — melkihm (posted on September 11, 2004)

September 11, 2004
Melissa, I hav a WLS exclusion in my policy. I have tried to appeal it 3 times and have gotten a no each time. My suggestion is to contact a lawyer. Go to obesitylaw.com. Walter Lindstrom and his wife Kelly are very experienced at this. They will let you know what your chances are in getting this overturned. They will let you know up front before they charge you anything if they think they can help or not. Hope this helps. Nicky
   — Monique B.

September 11, 2004
It was just on the news recently, that social security was revising their stand on WLS and would be approving some precedures. They set the standard for everyone. As soon as they have implemented this new policy, other insurance companies will follow suit. Are you able to wait it out? Just a thought.....
   — Leslie E.