Legal Question in Disability Law in Pennsylvania
HMO Exclusion of treatment of Morbid Obesity
My HMO has an exclusion of all coverage for morbid obesity, although other HMO's in PA and traditional ''fee for service'' insurance policies do provide coverage for morbid obesity.
How can I obtain the needed medical services for my morbid obesity that my primary care physician believes to be medically necessary for me?? Can this exclusion for morbid obesity be considered a violation of the Americans with Disabilities Act??
1 Answer from Attorneys
Re: HMO Exclusion of treatment of Morbid Obesity
I'm not sure that morbid obesity is a disability. Certainly, the definition of morbidity includes an awful lot of people lately, some of whom are quite healthy by athletic standards, so the diagnosis itself is probably not good enough.
Your best bet is to get additional coverage with another provider, or get another appropriate diagnosis.
On the other hand, if the insurer is in effect saying that it will refuse to cover ANY medical expenses if a person becomes morbidly obese, that, it seems to me is a gross violation of your economic civil rights, because obesity cannot always be prevented. In that case, it sounds like an ADA issue.
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