Question:
What does this really mean?

Here is what my insurance manual states under "Exclusions" : Weight loss. <i"Services and supplies to treat obesity, weight loss or dietary control even if they are part of the treatment plan for another Sickness. But the plan may cover some services and supplies for weight loss if the Claim Administrator determines that these services and supplies are Medically Necessary based on it's evaluation of your body mass index (BMI) and health status."</i><br> My question is, does this mean that they are saying that they will not cover it, or do I have a fighting chance? Thanks for your input.    — Joanne B. (posted on June 4, 2002)

June 4, 2002
Actually, I posted this and most of what I wrote was deleted and not by me. Not sure what happened, anyway, this is what it said, "Services and supplies to treat obesity, weight loss or dietary control even if they are part of the treatment plan for another sickness. But the plan may cover some services and supplies for weight loss of the claims Administrator determines that these services and supplies are Medically Necessary based on its evaluation of your body mass index (BMI) and health status." I was denied the first time with my insurance company requesting documention of 3 supervised weight reduction programs, one in the last year, one directed by a physician. I have given them information that my PCP and OBGYN made notes that I was trying to lose weight and that I was morbidly obese. None was actually directed by a physican. I do have a letter written from a friend who went through weight watchers with me in 1984, and I have two separate membership documentations from fiteness centers. What are my chances? Thanks
   — Joanne B.

June 4, 2002
In my opinion, you have a fighting chance. But you will need good records of failed weight loss. A friend's letter from 1984 most likely won't cut it. You can gain a lot of weight in 18 years. They want to see recent records. Your gym papers will help if they are not more than a few years old. If you think real hard, more than likely you do have supervised programs that you can get documents from. Any diet pills? LA weight loss? Weight Watchers? TOPS? You can include programs that you tried like Slim Fast. Letter's from friends are good, but make sure they are not too old. Write a good letter and if your denied again go to the top guy. Go to your ins. company's president. Good Luck.
   — Sarah K.