The insurance companies probably have a list of "approved" items and if it doesn't fit the list, then it is not accepted. There seems to be a question of semantics involved i.e. they may not cover needed neck massages, but if it's called some other kind of therapy, then it's covered. They cover TPN (intravenous feedings) but not the VHC or Jevity that goes into the peg tube so apparently we need to come up with something else to call the feeds that go down the tube? Or get a copy of the Insurance company's approved list and then make whatever you need to have fit one of their approved items. Jim I hope they approve the VHC for you. For anyone needing this, I don't see how it could not be considered a definite medical necessity when faced with losing weight and that without it the $2000 per day intravenous feedings may be what they could end up paying for!