Anthem Blue Access (PPO) Ohio

[Schwinn 0]

I have lurked on this forum for a while and have decided that I would be a good candidate for lap band surgery. I went to an informational seminar last night.

My insurance provider is Anthem Blue Access (PPO) in Ohio. I called them this morning and was told that my policy excludes any bariatric surgery, although it has been successfully appealed if it is medically necessary.

My BMI is just under 40 and as of my last check-up about 18 months ago I do not have high BP or any other co-morbidities. I do have a family history of hypertension, diabetes, arthritus, stroke. In the last year I have developed stress incontenince and have had a back injury.

I'm wondering if anyone else has had success appealing a written exclusion. I feel that my PCP would be supportive of me having the surgery and would work with me to get this approved.

Any suggestions?

Thanks

Schwinn

[MiniBand 0]

Check out the resources like how to write the letter, etc. at obesitylaw.com They have some ideas for the best chance at getting your surgery approved. The Library of The Obesity Law & Advocacy Center

Take care!

M