Payment might be denied because if there is an exclusion in your policy for obesity surgery or "treatment of obesity." An exclusion can often be appealed if the surgery is recommended by your surgeon or referring physician as the best therapy to relieve life-threatening, obesity-related health conditions, which usually are covered.
Insurance payment 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 — such as dieting, exercise, behavior modification and some medications — are considered to be available. Medical necessity denials usually hinge on the insurance company's request for some form of documentation, such as one to five years of physician-supervised dieting or a psychiatric evaluation, illustrating that you have tried unsuccessfully to lose weight by other methods.