UHC appeals

Time2StartLiving1107
on 1/26/14 1:17 pm - Avondale, AZ

Hi,

 

I have worked for UHC for over 5 years now and am trying to find out more about appealing the WLS. In my plan it is not covered. They said I could appeal it. My doctor wrote a letter of appeal last week and I'm praying to get some good news. Has anyone here every appealed the WLS and actually gotten it covered? If so please tell me about it.

hollykim
on 1/27/14 12:04 am - Nashville, TN
Revision on 03/18/15 with

sorry to say,if WLS is EXCL uDED in your plan,that means your employer,( the insurance company) did not buy the rider that covers it for their employees. If they didn't buy it for you,then that means the premium you pay for. Your insurance isn't covering. WLS. 

No amount of appeals/letters is going to change the fact that the rider is not being paid for. If someone isn't paying for the rider,the insurance company is.  Not going to cover it.

sorry and good luck

about your. Only option will be self pay

 


          

 

Time2StartLiving1107
on 1/27/14 12:23 am - Avondale, AZ

Thank you so much for your response, I guess I won't sit around and weight for the response lol. When I called them they said there were some adjustments made this year to the plan and I needed to send in the appeal. We'll see what happens but I won't bank on it.

ReginaPhelange
on 2/4/14 11:01 pm
RNY on 02/24/14

I was in the same boat.  My group plan was with UHC and WLS was excluded and the kept telling me to appeal. I did that and finally found out that my employer did not purchase the rider.  My doctor and I sent my employer letters explaining the need for this. They looked into it and later refused because the cost was to high. Doing my research I found out that the WLS ridder would have cost $1.04 per month to each employee.  That's it $1.04.   I got with a good private health insurance agent and she helped me find a private policy that covered WLS.  I left my group went to a private plan. My monthly premium is $30 more a month than my group.  My WLS was approved in less than 24 hours.  

You still have options. Don't give up.  

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