If an insurance says all treatments for obesity are excluded, does that include WLS?

My employer's insurance excludes WLS but specifically says surgery is excluded. I was thinking of getting a supplementary student plan through my university and found this under the list of exclusions:

"For treatment of obesity, regardless of the history or diagnosis, including, but not limited to the following: weight reduction or dietary control programs; prescription or nonprescription drugs or medications such as Vitamins (whether to be taken orally or by injection), minerals, appetite suppressants, or nutritional supplements; and any complications resulting from weight loss treatments or procedures"

Is this yet another WLS exclusion?

I had a glimmer of hope and am wondering if, because WLS is not SPECIFICALLY mentioned like in my other plan, if it could possibly be covered....

thanks, I'm so desperate.

I think you need to call them and ask. I belive it is probably excluded. Sorry, hope I'm wrong!

I would say it is going to be excluded... Sorry. But, the only one that can tell you for sure is your insurance co. Good luck on it

julie

It doesn't mention surgery, so maybe there is hope. The way I read it, it sounds like what they are talking about is stuff like Jenny Craig, Weight Watchers, diet pills, etc. But I would call them and ask.

I have bc/bs mi ppo, our policy states that it does not cover weight loss or treatment of obesity, ya da ya da yada... but when i called them and gave them the procedure code they said that it is covered as long as it is medically necessary and you follow all of their requirements, ie.. 6 month diet, psyche eval, and such. They said that you had to have a BMI of 35 with 2 co morbids, or 40 BMI with none. Also they said that if you had a BMI of 50 you didn't have to do the diet thing. Anyhow, don't give up hope. Get the Lap Band code and give them that when you call your insurance. That way you will know for sure.

Good Luck.