Question:
I have Untied heal care EPO- WLS is listed as an exclusion.

Will I be wasting my time with writing up appeal letters and such?    — Tracy B. (posted on January 17, 2002)

January 17, 2002
Hi, I am assuming you mean United Healthcare PPO. I Have the same. In the benefits book it looked like it wouldn't be covered. But when I called I found out that if I qualified (BMI 40, or 35 with co-morbs) they would cover it at 100% minus a $250 copay. I was approved in less than 2 weeks. If they denied you the first time I would definately appeal. You can even pay a lawyer to write the appeal (they may take you more seriously) if you can afford it. Keep trying, it is worth it. Good Luck!
   — [Anonymous]

January 24, 2002
For heavens sake at least try. What do you have to loose, other than a bunch of weight. I have battled for almost a year to get this surgery, and insurance companies want you to give up. But if you keep in their, hopefully it will pay off in the long run. I am scheduled for Mar. 4, 2002.
   — Dell H.

May 31, 2003
I also have UHC- EPO and due to the exclusion it was denied. I'm a little disturbed by the comment the anoymous wrote on 1/02, because I would have assumed the PPO was the same thing. I'm also angry with my employers for allowing exclusion to be placed in the insurance policy, and I wonder what can be done about it. When I applied for insurance, I didn't get a copy of the plan summary, just the plan worksheet. I now have learned a valuable lesson about reviewing insurance.
   — Rae L.

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