Question:
UHC DENIED FOR AN EXCLUSION BUT SAID WAS COVERES WHEN CALLED

DID ANYONE HEAR OF UHC DENYING A CLAIM BECAUSE OF AN EXCLUSION AND THEN WHEN I CALLED UHC THEY SAID GASTRIC BYPASS IS COVERED?    — redbone (posted on May 25, 2005)

May 26, 2005
A couple things I find out about UHC - government employee's espically mail carriers are covered and that UHC out of Georgia will cover but UHC of Wisconsin (or is Minnisota) will not. There are stories about being approved by UHC and then denied the day before surgery. My plan has an exclusion and everyone told me to not even bother to fight it.
   — Jenny X.

May 30, 2005
I had the same thing happen to me. I was told via letter that I was denied due to an exclusion in my employers policy. I called and they said I was approved. In order to have the surgery I had to wait til open enrollment and change from a PPO to a HMO. Under the HMO, my PCP was able to submit a referral and I then I was approved bc it was referred as medically necessary. Hope this Helps!
   — sunshinetari