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I have a bmi of 86. I am a 45 year old female with diabetes, obstructive sleep apnea and high blood pressure. My insurance policy has an exclusion for weight loss surgery but have informed me that my doctors and I have the right to appeal for medical necessity. Of course my reg. doc and surgeon are on board. Has anyone else ever had to appeal and then won?

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Check out the insurance forum, I have read on that forum that there are some who have appealed and won. When I had insurance that didn't cover the surgery I asked the agent about this on the phone. She said told me that it is the company which the insurance is through that decides if they will cover the surgery, not the insurance company itself. She also said that she had never seen an appeal won if the company had excluded the surgery. I never tried to appeal so I don't know if this is a fact. Good luck to you!

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