Linda-Fight, fight, fight. An apple a day keeps the doctor away but a letter a day drives the insurance company crazy and inundates them with paperwork that they have to answer. Take all of the objections noted in the rejection letter and respond to them point by point in your second appeal letter. If you go to the web sites of the major insurance companies you will find their policies & qualifications for gastric bypass. Use them and quote them. unless you are over 60, are wheelchair bound, have major heart problems or failed your psychological evaluation there is no logical reason they should reject you. Letters from your family doctor, your cardiologist, your pulmonologist and surgeon should be included in your appeal. Good luck. Alan