Question:
Has anyone talked thier emloyer into removing the written exclusion successfully?

Hello, my family and I have UnitedHealthcare choice plus POS and they have denied me due to the written exclusion and have denied my appeal. I have spoke with my husbands employer and he said he would try to drop the exclusion. I was wondering if that is even possible or ever been done or am I crazy for wishing for this dream to come true? I was wondering if anyone has done this successfully and how hard was it? I appreciate your time.    — Angela M. (posted on January 31, 2001)

January 31, 2001
HEY TRY WHAT I DID, I JUST GOT A ANSWER FROM THE GOVENORS OFFICE JUST TODAY, I WROTE HOW MY INSURANCE WOULD NOT PAY FOR MY SURGERY EVEN THOUGH IT WAS MEDICALLY NECESSARY. THEY WANT MY DRS. NAME AND WHAT MY HEALTH PROBLEMS ARE THAT WILL BE HELPED AFTER THE SURGERY WITH THE WEIGHT LOSS. IT LOOKS LIKE THEY HAVE GOTTEN THROUGH TO THEM AND I REALLY NEVER DID EXPECT ANYTHING TO HAPPEN I JUST WANTED THEM TO KNOW THAT WE WERE BEING DESCRIMINATED AGAINST JUST BECAUSE WE ARE OVERWEIGHT AND IT IS COSTING THE COMPANY A LOT OF MONEY TO KEEP ME IN MEDICINE AND GOING TO DOCTORS AND SURGERIES. THEY REALLY ARE SAVING MONEY IN THE LONG RUN IF I HAVE THIS DONE AND LOOSE THE WEIGHT, GOOD LUCK TO YOU AND I WISH YOU THE BEST. ALSO CALL YOUR LOCAL ADULT REHABILITATION AND IF YOU WORK IT IS A C HANCE THAT THEY WILL PAY FOR THE SURGERY TO KEEP YOU WORKING. ALSO THERE IS ANOTHER PLACE I CAN HELP YOU WITH IF YOU ARE INTERESTED JUST EMAIL ME AT [email protected]
   — Regina W.

January 31, 2001
An exclusion should not keep you from having a surgery that is medically necessary for you. If you are morbidly obese, this is a necessary procedure and should be covered. My policy had an exclusion for treatment & surgery for obesity but after the initial denial (a test for you to see how serious you are) I was able to get it approved by letting them know that they could NOT deny me. I can send you what I sent them if you are interested.
   — Lisa B.

April 19, 2008
I have the same insurance you do and having the same problems. What happened for you? Did you appeal a second time? Any help is greatly appreciated!!
   — sheilagirl98

September 22, 2008
lisa, can i see the letter you used to help change the minds of all?
   — I_ride_on_the_back

January 22, 2009
Hi Lisa, I also have the same insurance. I would love to see any information that you think could be helpful.
   — sassysco1974

April 2, 2009
I have the same insurance with the same exclusion. Any one that is willing to share information on how to successfully go through the appeals process and get approval I would greatly appreciate being contacted through the website. I can give private email once contact is made here. Aany and all help is greatly appriciated. we all need to advocate for each other. Thanks Lori
   — abuddingrose

April 16, 2009
I'm going through the same thing right now. I called my insurance company and they told me that since my employer didn't choose the obesity treatment option, they won't cover it. What can I do? I have several other medical issues and believe the surgery would resolve a lot of the other problems. I go to my information session on the 27th and hopefully I can get some direction. How can I get around my employer not choosing that option? The new plan year has already started. Can you get the employer to add the option 'mid stream'?
   — hunterholt

July 23, 2009
I am another one that has an exclusion on our health insurance. I was told by the benefits person that I could appeal to BCBS but would probably be denied. Any informatoin on how to go about this would be appreciated. email me at [email protected] Thanks everyone for your support. This web site has been soooo helpful. Nancy
   — Nancy W.

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