Re: Exclusions and Limitations questions

[Guest guest]

yep, that morbid word has made a difference as well as being

medically necessary. my ins. had similar wording, and i had to

have a letter of medical necessity. plus i need to lose more pounds

than i should end up weighing. i believe that i am/was super

morbidly obese. so the wording you quoted should not rule out

approval automatically.

hope this helps

mary y

> Hi all, a little input needed here for potential insurer:

>

> Does anyone have insurance with this or a similar statement? Is it

your

> experience or opinion that since " morbid " is not in there, that

they would

> cover if medically necessary?

>

> " Gastric stapling, gastric banding, gastric bypass and experimental

or

> investigational procedures for the treatment of obesity are not

> covered. Also excluded are nutritional counseling and weight

reduction

> programs. "

>

> Thanks for your help.

>

>

>

>

>

>

>

> Hawkins

> Preop / BMI 60 /

> 240 to lose / 150 lbs bound!

> Appealing First Denial, B & T 10-17

> Rabkin in SF

>

> ****** Hoping soon for a switcheroo! *******

[Guest guest]

Yes , and the two are even coded differently, xxx.0 and xxx.1.

Different conditions!

Chris

> > Hi all, a little input needed here for potential insurer:

> >

> > Does anyone have insurance with this or a similar statement? Is

it

> your

> > experience or opinion that since " morbid " is not in there, that

> they would

> > cover if medically necessary?

> >

> > " Gastric stapling, gastric banding, gastric bypass and

experimental

> or

> > investigational procedures for the treatment of obesity are not

> > covered. Also excluded are nutritional counseling and weight

> reduction

> > programs. "

> >

> > Thanks for your help.

> >

> >

> >

> >

> >

> >

> >

> > Hawkins

> > Preop / BMI 60 /

> > 240 to lose / 150 lbs bound!

> > Appealing First Denial, B & T 10-17

> > Rabkin in SF

> >

> > ****** Hoping soon for a switcheroo! *******