Question:
will this exclusion pay for wls
looking for a new insurance. if it says it excludes weight loss treatment and exogenous obesity will it pay for wls. please help!! — [Anonymous] (posted on January 26, 2002)
January 26, 2002
Doesn't sound like it ~ but give them a call and ask. Sometimes they may
still cover it even if it is excluded, just not quite as easily. Good
Luck!
— Laurie A.
January 26, 2002
Please, don't stop at a phone call. My policy had similar wording and when
I called they said NO,flat out they would not pay. I went to my first
appointment anyway and let the Dr take it from there. After months of
playing the waiting game, they finally relented and paid for a good portion
of my surgery.Good luck and don't be discouraged. Diane
— Diane D.
January 27, 2002
yes, dont stop at a phone call,I called my insurence company last june, and
they said no, my exclusion does say that it wont cover weightloss unless
its obese, and she told me that ovese ws very big. I told her that I
weighed about 230, and she said, no, thats not nearly heavy enough,
obesisty is a wieght like you need to be lifted out of your tub with a
crane, not my size. so, other then feeling really stupid, I left it alone.
Untill Carnie Wilson had hers done, and then I looked into further, and
found that obese is anything over 40 bmi, which is me. I could have have
been alot further on our journey, then I am. I am still waiting for this to
all happen, inusrence denied one, so I had to get all of my stuff in order,
and its just been submittd again. So, we shall see. Yours sounds like it
doesnt cover it, but please, dont quit trying, keep looking into other
things, also. Good luck to you
— amy T.
January 27, 2002
I'm not sure how you found out your insurance has this exclusion. I called
my insurance company and asked them and they told me it wasn't covered. I
said I wanted to see it in writing. She then sent me a page from the
exclusions part of the policy. Lo and behold, it doesn't cover any weight
loss treatment, EXCEPT surgery for morbidly obese. There are some
conditions you have to meet, but for anyone who is morbidly obese, they
aren't hard to do. NEVER take your insurance company's word for what they
say on the phone. Always get it in writing. You should also be able to
get a copy of the policy from your Human Resources department.
— garw
January 27, 2002
First find some surgeons and attend their support group meetings. See and
hear the surgeon and staff, do you WANT these folks to care for YOU? Once
you get that out of the way ask about YOUR insurance company at the
meeting. Fast easy educational way to answer your question. Picking a
surgeon is like anything else.... SHOP AROUND! Of course personal referrals
are really good, but do meet your perspective care giver, and ask lots of
questions. I wouldnt pick a surgeon without doing this first.
— bob-haller
January 27, 2002
Sometimes insurance companies write these exclusions about obesity surgery.
I know mine has such an exclusion. But then they have an exclusion to the
exclusion *sounds funny, I know* that states that they cover obesity
surgery if you're MO. So, check it out.
— tmrivas
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