I was wondering about appeals. I have not yet started the process, so this is me just thinking of all the avenues and I am dedicated in getting this this year soon as I am done with not being able to enjoy life how I want to (that is for another post). But I just switched to my husband's insurance that does cover gastric surgery. The plan says you must try other avenues for a year. On that note, while I was on my own insurance plan that did not cover it I have been under a doctors care for weight loss and diabetes. Do you think I can appeal under the notion that I am under a doctors'a care for a year because of obesity? Otherwise I would wait a whole other year with this new insurance or find another means of getting banding done. Any thoughts on the likelihood of an appeal working? BTW I should add I have been on a leave from work due to all these medical conditions, the weight has aggravated my sciatic nerve and I haven't been able to withstand standing or sitting for any period of time. Yes odd part is I have lost about 50lbs from the previous year I worked. I also have had nerve surgery in my arm and most likely will need it again before returning to work (also due to weight issues); and suffered a major fall which has done nothing but set me back in any rehabilitation I have done. I guess my overall question is with an accumulation of medical issues documented for years is an appeal likely?

If you've selected a surgeon, their insurance staff would have a very good idea how appeals work with your insurance. Since bariatric surgery isn't a standard covered item, they appeal and work with insurance companies every day.

My doc's administrator was very good with appeals and mine was approved the first time. Important they understand your insurance guidelines. What state?