UHC -Pre Existing Condition

I am very upset and very angry...I need to know the truth...

So before I had WLS I had all my ducks in a row.  My insurance (UHC) approved my surgery.  They made my surgeon's office gather all kinds of information including 5 years of medical history showing that I was obese.  Now they are not paying because my policy has  "pre-existing condition" crap...what the *&$@!!!  I am so upset...it's like they tricked me to say that I have been obese for 5 years to turn around and say that's pre-existing...I hope it goes through, I don't think I could afford to pay $20,000 right now, that would break me.  Did I say I was upset?  Any ideas on what this will do?  I had an insurance with another 3 months before surgery so I think that's what is bugging them...I just wish they would have told me this before having approved me for surgery...such crooks!!!!!

uhc is shady. I was surprised at their actions. Alot of people say they are great but I have had nothing but problems.

Wow!  I am sorry for the issues that you are experience with UnitedHealthcare. When you looked over your policy before pursuing the surgery, did you read any information about coverage for pre-existing conditions?  Usually, in explanations of coverage (or something similar), there is information on how pre-existing conditions are handled if at all.  What did your policy say?  Did you receive any information from your human-resources department about your benefits and how they cover you?  Did you contact UnitedHealthcare to ask for a copy of your benefits? It is unfortunate, however, that no one at UnitedHealthcare took the time to go over the details of your policy as well because when I worked with them and quoted benefits to members or doctors, one of the first things that I did was check for pre-existing clauses on policies, as these policies will color how your benefits will pay.  What's even more unfortunate is that UnitedHealthcare does not like administratively pay claims (meaning pay claims for errors made on their part), but they have in the past--albeit with the threat of legal action. If your benefits are through your employer, then you might want to explain the issue with your human-resources department to see what can be worked out.  If there is an administrator for your benefits, talk with that company to see if it can provide you any assistance.  However, please be aware that knowing the details of your policy ultimately is your responsibility since any financial responsibilities associated with your coverage will fall to you.

Here's the deal with GROUP insurance and pre-existing conditions (individual insurance is entirely different): They can ONLY deny you for up to one year for any pre-existing condition and they cannot deny you at all if you meet this criteria: If you've had insurance for 12 months prior to becoming effective with UHC without a lapse of more than 62 (or 63, I can't remember which) days. If you only had coverage for three months they will give you credit for that three months (call your previous carrier and ask them for a "HIPAA certificate" or "certificate of credible coverage") so they can only deny you for 9 months, rather than 12. But if you do have anything done related to a pre-existing condition within the months of the pre-ex investigation, they can and will deny all claims. But the good news is that they can't deny you forever.