Why are people denied coverage?

[Sleeve_Sistah85 193]

Just curious...

What are some common reasons people are denies WLS by their insurance carrier?

[Jacqbult 112]

I think one of the reasons is too low a BMI. I am not sure as I am waiting approval...UGH~

[Walter Lindstrom 42]

We have the answer to your question on our wlsappeals.com website. Here is the link:

http://wlsappeals.com/common-bariatric-denials/

Hope that helps! Good luck!

[Kindle 8,667]

WLS is excluded in a lot of policies. Employers can opt out of including it. States can also opt to exclude WLS in the individual policies offered through the affordable health care act. (Mine does). No

[hdbratt 2]

My plan with Aetna doesn't cover it or so it states in my benefits.

[Maggie Diaz Saldivar 2]

Ive heard that even if your plan clearly excludes it and you have 2 or three other issues such as diabetes, hbp, sleep apnea, depression, etc that it then becomes medically necesarry and they cover it. Any one know if this is true. This info came from a WLS patient that had Cigna and her policy excluded it.

[Kindle 8,667]

Ive heard that even if your plan clearly excludes it and you have 2 or three other issues such as diabetes, hbp, sleep apnea, depression, etc that it then becomes medically necesarry and they cover it. Any one know if this is true. This info came from a WLS patient that had Cigna and her policy excluded it.

You'd have to talk to your insurance company. Mine is worded such that WLS is never considered medically necessary no matter what illnesses or weight-related issues you have.

[Seymour1971 55]

I talked to Aetna an affordable care plan and they said they didn't cover. True results red oak/Hollis, could tell I had hietal hernia just by a questionnaire. The patient advocate said even if it was hairline in size, the insurance would cover. Again, we paid 2500 for everything...