Question:
Does anyone have United Healthcare choice plus with a written exclusion on obesity???
I have now been denied twice for approval for the gastric bypass sugery and I wanted to know if anyone has been approved that has the same insurance policy as myself with the written exclusion. Any help I can get would be deeply appreciated. I found out today that my 1st appeal after the original request that was submitted by my surgeons office had been denied again and if I find other people out there that had been approved it would give me a little hope. Desperatly Julie — julie C. (posted on November 5, 2002)
November 5, 2002
I have UHC EPO and was denied because of an exclusion. They said WLS was
not covered at all. I worked with my HR rep and they ended up approving
it. You may want to try this, it may help! Tomorrow is my surgery date!
— Sharon F.
November 5, 2002
Julie, I too have been denied by UHC due to a written exclusion policy. I
have been fighting with them since July with my PCP, surgeon, HR girl at my
office and an insurance broker. All are supportive of my surgery as my BMI
is 55. I'm still waiting to hear back from my first appeal. I hold out
little hope as I contacted Walter Lindstrom and he said he had never won a
case against UHC. I heart goes out to you and I wish you luck. Let me
know if you prevail! I'm still keeping my fingers crossed and hoping for a
miracle for myself. It's a travesty that this surgery should be excluded
from policies at all!
— SMG I.
November 5, 2002
I have the same insurance, and was approved in 2 weeks for a VBG with no
problems.
— salymsmommy
November 7, 2002
Julie,
I feel your pain. I have the same insurance here in GA. I have learned
alot since starting this process. First thing you have to do is determine
WHO has the exclusion, the insurance company or your employer. That is who
you need to address your appeals to.... Mine is the employer, obviously out
of ignorance. I have submitted paperwork and copies of the wonderful
(useless) senate bills we have here and still my fate rests on the decision
of SOMEBODY (still not sure who makes the final decision). So far all I
have gotten is the opinion of several people who know nothing about this
surgery. The employer has the power to remove the exclusion if it is thru
them. All the appeals in the world won't work if the employer has the
exclusion and refuses to remove it. I have heard UHC is very hard core.
My hope at this point is thru my hubby's insurance, he switched just for me
to hopefully get approval. I have been at this for nearly 2 years now.
Hope this helps... good luck... Pam in GA..
— Pam B.
November 16, 2004
Hello, I have uhc choice plus and there was a written exclusion in my
policy for this surgery but after about 2 months i was approved. I did not
have to write a letter or anything. I was never denied it was in review for
a while but they did approve it so cheer up and pray you may have the same
luck as me
Geneane Brooks
open rny
06/22/04
— chinadol262
November 16, 2004
I too have UHC with an exclusion in my husband's policy. I have been 2 yrs
trying to get approved. I have lost all my appeals even with legal help. My
husband's employer said that he would do "whatever it takes" to
help us. Well going to have UHC again 1-05 & they have the same
exclusions!! I have 7 doctors (5 of them being surgeons) trying to get the
RNY approved for me. I decided to go on medicare& along with that I can
get wellcare, humana & uhc(ugh!). I took wellcare & I'm having to
fight again. One doc told me to switch to humana so I will. Pray for me
that either wellcare will approve before I switch or humana will approve
me. I wish you the best of luck !! Let me know if you get approved.
— yellow T.
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