Question:
sample letters/literature

I keep getting my hopes up, then they were crushed when Erin at lifeguard told me that the insurance company is not saying WLS is not a medical necessity, but it is a policy exclusion. The nurse at my surgeon's office says an appeal will likely be similar to banging my head against the wall due to her past experience with Lifeguard. I had to laugh when I heard their ad on the radio "Lifeguard on your side, not in your way" It's crazy they will pay for the consult but deny a surgery that two prominent surgeons indicate I should have. Anyway I need some advice and copies of any appeal letters anyone out there is willing to share. Please accept my thanks and gratitude in advance for any advice or sample copies of appeal letters/literature. I am feeling ready to fight with these biast folks as I'm tired of the attitude that morbid obesity is a moral and not a medical issue. God Bless    — Diana D. (posted on February 2, 2000)

February 2, 2000
DIANE, I AM ALSO HAVING TROUBLE WITH THE INSURANCE COMPANY WHICH IN ANTHEM BLUE CROSS. I ORIGINALLY HAD NORTH AMERICAN BENEFITS WHICH DENIED IT. THEN I TOOK OUT INSURANCE ON MY OWN THE BLUE CROSS. ITS ONLY BEEN IN EFFECT SINCE JAN 1, THEY HAVE DENIED IT TWICE SINCE. THE SURGEONS OFFICE IS STILL IN PURSUIT. I AM GETTING VERY DISCOURAGED. I COULD ALSO USE HELP WITH APPEAL LETTERS.IF YOU NEED TO TALK YOU CAN CONTACT ME.
   — Deborah K.

April 24, 2000
I am currently struggling with the very same situation. I have not actually gotten an denial, but I feel it is imminent. I hope everyone on this list whether having had surgery or wanting to have surgery will assist in writing to your Federal Congressmen/Senators. Since NIH has declared obesity as disease of epedemic proportions, insurors who get away without treating this "disease" due to an exclusion clause will soon be turning down treatments for diabetes, heart disease, cancer, etc. This group of folks understands that obesity/morbid obesity is NOT willful misconduct, but a horid disease that robs folks of dignity, health, and life itself. I urge everyone who comes to this web site to take a pen in your hand and begin writing letters to the Congress. Senator Bill Frist (R) TN is the only physician presently who is a member of the Senate I believe. I have not yet contacted Senator Frist but hopefully will be able to persuade him to introduce some legislation about such as he is a physician and is on most of the important medical subcommittees because of his medical background. However, anyone and everyone you write to will help in this struggle. It will take Federal legislation to overturn the insurors who hide behind such exclusionary clauses. My insuror, BTW, is United HealthCare of KY.
   — jeff P.

April 25, 2000
After reading Jeff reply I had to also put my 2 cents in *Smiles*..If your unfamiliar with my situation,ive appealed 3 times with my insurance and have been denied, due to a very simple exclusion clause.(That they stand behind 100%).Now my situation has taken a turn, because recently my hubs has taken a new job(Just this week) so we will be picking from 3 insurances, and of course that will be something I will be looking for. But enough about me, What im posting about is, the legislation that seems to be NOT passing in the United states. Ive had some very good luck with my public officials, and yet not sure if they are just trying to get me to shut up or actually doing something. But what amazes me, is this, That not MORE morbidly obese people, ones that have had the surgery and ones that are having the surgery, and ones that WANT the surgery arent doing more to change the laws. Ive posted several times on address and links, and email address for Ohio Public officials,and have gotten very little response from it. I Realize that all of us are on a emotional rollercoaster, and feel like we cant take anymore on. And yet I guess my heart tells me that this surgery doesnt change that im a morbidly obese person, Sure it allows me the chance to loose the weight, and eat healthy, and gives me a chance to live a "Normal" Life, but I will be always a morbidly obese person. Just as a Alcholic is always a Alcholic. The outter part may change but the inner will always be. Now im sure I Will get alot of feed back on this, and alot of people may disagree, and im not saying each person should feel that way.Thats the way I FEEL!. So that feeling makes me concerned about the other people that will be discriminated agaisnt, laughed at, and be told NO by a insurance company that is sending out the message that you are NOT worth saving, because you are morbidly Obese. And not only is the insurance companies the enemy, but we are too. We allow the Government to allow these insurance companies to do this, to us, and people we love. We allow the discrimination to continue because we are afraid to fight, or believe that we cant make a change. And yet in the past you know that when people stand up and demand to be heard, HEARD THEY SHALL BE!. With all the research ive done on WLS, And know that it is the 2nd Leading cause of DEATH, I Cant believe that more people have not rallied togeeather, to say Here we are , we are not going away, and we DEMAND CHANGE. To do that, means everyone, the ones that have had surgery and the ones wanting, and the ones that dont even need it, but can imagine on a daily base what we (morbidly obese) Go through. We need to educate, we need to fight, and we need to get INVOLVED!. I Know ive rattled on, but please take the time to write your congressman, get involved, and get OTHERS involved. This is about saving Lives. Is there anything more important? *Smiles* Thanks for reading :o)
   — Ann A.

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