I was denied by my insurance company and plan on appealing the denial. Does anyone have a copy of the letter they submitted for the appeal? Any suggestions for the appeal? Any help would be greatly appreciated.

Out of curiosity what is your insurance company?

Blue Cross Blue Shield through the plumbers union.

Hi Kerri76

I was also denied and plan on appealing. I found this letter that one of the members posted. I plan on using it myself. Hope it helps. good luck!

Dear (insurance Provider contact),

I am appealing your decision for denying my medically needed weight-loss surgery. My ht and wt are __ and __ and my BMI is __. As statistics show and as medical doctors, you must be aware that diet and exercise help, but as a long term resolution to permanent wt-loss only 5% of people succeed. I am well aware of the risks with this surgery, but I believe the risks of being morbidly obesity out weigh the risks of surgery.

I am _ years old and have been over-wt since I was _ years old. I have been on diets my whole life, having some success, but would always gain the wt back I lost, plus more. I will list the diets I have been on, but never kept any documentation because I could not have known at the time the insurance company would require it. Nor did I know that until this fairly new surgery even became an option for me, I would have to document wt loss before getting the surgery.

(list ALL diets, wt- loss products, programs used. If possible, use documentation.)

I have many co-morbid diseases, such as ___. (list meds also). You can also list family history related to obesity here.)

(discuss everything about how morbid obesity affects your life)

Sincerely, (your name)

__________________

Hi kerri76,

I am going through the same as you I have been denied twice. And now am starting the appeal process. If you go to www.lapband.com and search appeal letter they have a really good one also. I also like the one below from sweetsagi. I have bcbs of iowa. Did they say what the reasoning was on your denial? Mine was part of the 3 years I was pregnant and the right before my BMI was 38. I now have BMI of 45 and have hypertenion and high cholesterol.

Let me know how it goes.