How can they deny insurance coverage for a life-threatening disease?
Coverage may be denied because there is a specific exclusion in your policy for obesity surgery or “treatment of obesity,” which is manifestation of the attitude of our society toward obesity, and the discrimination which obese persons suffer. Such an exclusion can be challenged by the reasoning that the surgical treatment is recommended as the best therapy for the co-morbidities, treatment of which is usually covered. Coverage may also be denied for lack of “medical necessity.” A therapy is deemed to be medically necessary when it is needed to treat a serious or life-threatening condition. In the case of morbid obesity, alternative treatments are considered to exist according to conventional wisdom such as dieting, exercise, behavior modification, and some medications. Usually medical necessity denials hinge on the insurance company s requirement of some form of documentation, and the best approach is to try to produce reasonable information to encourage them to approve payment for th
