Denied by UHC!!!

UHC has denied me for WLS based on the fact that they say it is excluded in my contract. I have been going through this process for months, testing, my Dr's office has spoken with them several times and been told it was covered. I called before I even made the appt with Dr. Graber and was also told it was covered. I am hysterical. I was on the phone crying to the insurance company for half an hour to no avail. All this pre-op testing has cost me almost $1000 in deductibles and co-pays and this is what happens!!! 14 days before surgery they give me this information!! I know I can appeal but from what I have read I won't probably be successful. I have looked all over the insurance website and found NOTHING that excludes treatment of morbid obesity. Has anyone else been through this?

Hun i just wanted to post and say that I will keep you in my thoughts and prayers that you can appeal and get the surgery....i HATE these Ins companies! Please do not give up and let them win. I am sorry you are so upset and it is understandable, let yourself be upset and then turn that hurt into anger and work on getting this appealed! You can do it!!! please keep us posted hun. Debra P

Keep the faith, I switched to UHC and was approved in less than a week for my lap band! Good luck! Kenny

i was also denied by my insurance. onpoint bc/bs. they have a listed exclusion on their policy. bariatric ctr said it would do no good to appeall. so i have to wait until the beginning of the year to change my insurance to mvp. it will be more $ but hopefully it'll be worth it. can you change your insurance carriers? best of luck to you. keep up the faith for us.......... sue;

Forgot to add this link for possible assit as well: http://www.wlsadvocates.com/ The lawyer was in article in WLS Lifestykes 1st Quarter 2006 Stacy Posner, she had WLS. http://www.sunmetrosys.com/wls/Article.pdf this has full article! Jamie

ASK for a copy of your policy, specifically where it states Bariatric Surgery is an exclusion. Remember I may have insurance company X and you may have insurance company X but my employer has different policies/riders/exclusions than your companyt htis is how you may be denied and I approved. Only your policy matters. Think about enlisting help of Walter Lindstrom a WLS attorney! http://www.obesitylaw.com/ Here is a helpful link as well: http://www.obesityhelp.com/content/insurancetrouble.html Here is a message board for insurance issues: http://www.obesityhelp.com/forums/insurance-help/posts.html I am sorry you're struggling with this right now. Take Care, Jamie Lap RNY 10/9/02 Dr. Singh 320/163 5'9'' (lost 45# before surgery) Plastics 6/9/04 & 11/11/2005 Dr. King http://www.obesityhelp.com/morbidobesity/members/profile.php?N=c1132518510 "Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"

Thanks for all the advice. I am just so frustrated right now. I am going to appeal but according to the FAQ section on Obesity Law.com exclusion appeals are the hardest to win. I do have this: ~My Dr's office claims to have dates and names of the three calls they made in which the UHC rep stated that the surgery was covered ~When I log into the UHC website with my user name and password there are no exclusions listed under the policy information. In fact, UHC maintains that I and Dr Graber's office should have known that the surgery wasn't covered b/c the ins would not cover my nutritional counseling. HOWEVER, my policy coverage info on the website states that nutrition counseling is covered under my plan. (HMMM...) ~I know for a fact that I was never provided a complete copy of my policy before re-upping last year and if, in fact, the policy info I received does not state the exclusion of all treatment for morbid obesity it is basically a fraud by omission. This info is available on our company's personnel website but my password is not working so I am now waiting for a new one. I have copies of all of the website stuff and my dr's office is sending me their records and writing me a letter of support. I also have to say that Dr Graber's office was so upset for me and apologetic. The staffer swears to me up and down that they did everything they were supposed to and I believe her. Besides, they cannot possibly know the ins and outs of every policy out there and they did their job when they called those 3 times. It is not their fault they were given incorrect info. Through all this I am just assuming though that my appeal will be denied. I saw another post on getting the state of NY to overturn. Has anyone done this before? How do you get it started? TIA