Question:
With an exclusion to the policy, can I get appeal & get approved for back problems?

I have a BMI of 49, years of documentation on back problems, asthma, cholesterol issues, etc.However, I have been denied and I am trying to get approval on an exlusion to the policy(secondary insurance). Regence is my primary(no hope there). I need to prove a medical necessity. I need to write an appeal letter, Please Help!!    — Lawney R. (posted on June 21, 2003)

June 24, 2003
Appeal your insurance company's decision of denial. Send a cc: to your state's insurance commission. Call your state's insurance commissioner and inform then that WLS is medically necessary however your insurance company refuses to approve. The insurance commissioner will become involve and will help. That's what I did. Actually I didn't even have to call my state's insurance commissioner. All I don't it cc: Florida State Commissioner Office on my appeal letter. That kind of puts the idea in the insurance company's head that you know what you are talking about and you are very serious. Good Luck
   — Jeanette D.