Question:
My UHC policy under Exclusions says

except that non-surgical treatment of morbid obesity is a covered health service when provided by or under the direction of a network physician." I don't think the wording is specifically stating that surgical treatment of morbid obesity is not covered. They only say that obesity is not covered and they say that non-surgical for morbid obesity is covered. Has anyone seen this and do you think I have a chance to fight it for not being clear? Brandi F    — Brandi (posted on August 19, 2005)

August 18, 2005
Hi, I have United Health Care PPO and had the surgery FEB 03. It was fully covered except the hospital stay which was $200. They approved me about 2 wks after it being requested. I was lucky but If they deny you... FIGHT IT, APPEAL as many times you need to. GOOD LUCK =)
   — mamita093

August 19, 2005
I have UHC choice plus thru Delta Airlines. Mine was worded very similar to that. I was approved by them and had my surgery done 2/15/05. The deal with it was this: They covered 80% of the surgery, doc visits, testing, etc. BUT they WILL NOT pay the surgeon or surgeons assistant to perform the surgery. My out of pocket for the whole deal(visits, testing, psych exam, hospital stay, and follow up) ended up being close to $9000. Out of that $6500. I didnt have to fight at all. I had my first consult in late december 04, all my testing and submited to insurance January 05, approved mid January, surgery was 2/15/05. It was suprisingly easy to get approved! I hope you have the same luck! Call and talk to your HR and the insurance companies and see what they tell you
   — Skinny Mama

August 19, 2005
It looks like they cut off the first part of my exclusion. It says "surgical and non-surgical treatment of obesity, except...... and the rest of my originally post above.
   — Brandi

August 19, 2005
Brandi, I also have that statement or something similar in my policy, I am fighting them to have surgery. I know UHC does approve the surgery. Someone where I work with my insurance was approved after the 4th appeal. So it can be done. Good luck and don't give up. Kathy
   — katydyd

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