Question:
Ever been approved when your insurance co has an exclusion clause?

Has anyone ever won an appeal where they were first denied because their insurance company has an exclusion to the policy regarding bariatric surgery?    — nerlinger (posted on May 13, 2009)

May 13, 2009
Nicole: I have an exclusion on my health insurance polocy(United Health Care) and will have to appeal;even though my information has not been submitted yet (will be in June or July). I have some information and have done a lot of research on this and am willing to share any and all. I can be reached here or at my eamil address [email protected] feel free to contact me any time
   — abuddingrose

May 14, 2009
My understanding is that, unless the exclusion has the statement included that says "unless proven to be medically necessary", you are out of luck. Or unless it is only excluding certain WL procedures. An exclusion is just that. An exclusion and no way to get around it.
   — corky1057

May 15, 2009
I had an exclusion in my insurance. I fought with them for 2 years and I even had a meeting with the general doctors that work for them. And they still wouldn't budge. I submitted documents for other doctors. I have rheumatoid arthritis and that didn't even help. When it says exclusion, boy the meant it. I ended up getting a loan and just paying for it myself. Good luck
   — okbuffy

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