Question:
Anyone have UHC with an exclusion?

Has anyone had United Health Care Choice with a written exclusion and had no problems having surgery done? My BMI is 53 and have an exclusion but waiting for approval from them. Just wondering if this is going to be a real problem.    — Shelley S. (posted on January 24, 2005)


January 24, 2005
I hate to be the bearer of bad news, but I too had UHC with a written exclusion and I was denied. I contacted Walter Lindsrom (obesity lawyer) and he told me that UHC never bends. I ended up being a self pay. Unless the words "unless medically necessary" are in the exclusion you will not get approval. Best of luck.
   — Baby Blues

January 24, 2005
When I first tried to get approval for this surgery in 2003, I had uhc ppo and my employer did have an exclusion in my policy. I fought them on it for about 8 months and after my 2nd appeal, they said they will not nor ever approve this surgery under that policy. I contacted walter lindstrom and he said that there was not much he could do if my employer had the exclusion. I finally had to find another job that offered coverage. You can send in your appeals, but just be prepared for bad news. I am sorry. Take care and good luck, jeannie
   — harleigh2002

January 31, 2005
I have Uhc and when I called to see if it was covered they told me it was and no exclusions, I sent in all of my information and a week later I was denied, I have a bmi of 63 and 8 co- morbids, I then called them again and they said I had a iron clad exclusion in my policy , I called my employer and they found out there was a glitch in the systems at UHC, I am getting a paper from my employer to overturn the denial, hopefully everything works out with you....
   — iamhappy200




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