Question:
cAN ANYTHING BE DONE AT ALL FOR AN INSURANCE EXCLUSION?

mY INSURANCE HAS AN EXCLUSION FOR WEIGHT LOSS SURGERY. (Texas TLM)is there any hope for me other than selfpay? I am a poor school teacher and don't have $20,000!    — Cindee A. (posted on March 8, 2001)

March 8, 2001
Appeal to your employer! I did and they have agreed to pay for mine! Make sure your doctor words his recommendation in such a way that it defines that it is life threatening for you not to have this surgery. That your quality of life is impaired and so forth. Good luck!
   — Sharon R.

March 8, 2001
An exclusion does not mean they won't pay. My policy had an exclusion but paid if the surgery was medically necessary. If your BMI is over 40 - you qualify with no comorbids and if BMI is over 35 you qualify with comorbids. Don't let them brush you off. According to the NIH you qualify under these conditions and they should pay.
   — Lisa B.

March 9, 2001
My exclusion was not able to be overturned...it didn't matter that they paid for medically nesc. surgeries...I was a selfpay and tried everything I could to get it covered since I have double cover insurance....Not all exclusions can be fought(maybe most).
   — Debora H.

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