ANYONE every appeal a plan with an exclusion for weight surgery and got approved !

mswyatt1967 · May 2, 2016

Hi I'm just wondering if anyone ever got a policy that excludes weight loss to cover their surgery after an appeal? I'm so upset was in my 4th month of 6 supervised diets and my fiancé lost his job so there goes my coverage, my job actually excludes weight loss, And I was just wondering if anyone has ever gotten their ins to cover it after and appeal are something even though it was an exclusion, my advocate thinks I should go ahead and finish the six months in case I get coverage again, but I was thinking about finishing it and then appeal through my ins, so was just curious, thanks in advance!

atlmag · May 2, 2016

Sorry to hear about your situation but it's an exclusion so you won't have a chance to appeal because it's not a benifit on your policy. Many employers optout of the coverage (if state law allows) to save money, I think a lot of insurance companies put the enclosing in with out the employer relizing it. Some doctors offer a substantial discount if you have a hernia that's needs requires surgery or look into the Mexico option. Another option is to see if any policies on the health care exchange offer coverage.

mswyatt1967 · May 2, 2016

Okay thanks a lot for your response

KristenLe · May 2, 2016

Confirm what that means for weight loss to be excluded. I read a policy that indicate weight loss programs were excluded but not Bariatric Surgery. You may want to talk with your plan administrator. I would go through with the visits - as they should count even if you get a new plan next year.