United Healthcare exclusion for wls

I work for PSTA IN Clearwater. I received our UHC benefits book today and they have a new exclusion of surgical and non-surgical treatment of obesity, including morbid obesity. This plan started 10/1. The old policy included medically necessary. I called UHC and was told by a supervisor that I couldn't file an appeal if I am turned down because it states it is an exclusion and I have no recourse. My ankles, knees and back hurt and I am at least 100 lbs overweight. I can't go to my company because they are the ones that chose this exclusion and it's like talking to myself to get any help from them. I have high blood pressure and I have heartburn every day and live on rolaids. Does anyone know how I can get around this hurdle? Any help would be appreciated. I have started the wls process with Dr Rehnke and I feel like I've hit a major roadblock. Thanks, Betty

WOW...sry to hear that... I have United Healthcare but as you have found out your company decides what is covered and not covered. I work for a Hospital they have an exclusion also but with one exception They will cover a RNY at the hosp I work at only. I can't go out of network. (They just started doing them, only have done about 30 but what other choice do I have)..I wish you the best of luck...Hope somehow they can get you approved..

Hello! My company switched to United Healthcare and I read the exclusion. I called three times and they told me the same thing.They told me that it was not covered. Well, I hate the word "no". I kept calling and wrote them. Finally after several calls . I talked to a different person each time. They told me that they will cover it ,only if medically needed. My case is pending because they do want everything. Psch,gastroentr.,pulmon. , dietician. They have paid for all these consults except for the normal co-payments. The dietician was the only one I had to pay for $150.00. Sleep apnea is very important! I have sleep apnea,high blood pressure, low back pain,diabetic and depression. Through all these consults,I have had a full physical. I am forty-four years old and this was my first true physical. I found out through a endostopy(not the way to spell) that I had a bateria in my stomach that was causing damage to my stomach. I was having few prblems with my stomach also. After a week of special treatment with a special antibiotic combination,I am fine. If untreated,it could have caused a ulcer. Continue on,sister. God is in control ! Not the insurance companies.See you on the losing side girl !

I have UHC, but we have no exclusion. In fact, I am being banded with the lapband by Dr. Grossbard in Z-hills on Monday. I also according to my first surgeon had the bacteria (h.Pylori) and had to take the mixture of medications (prevacid & Flagyl for 2 weeks and then tetraccycline & pepto for 2 weeks). Now, I am fine. waiting to get to the losing side! Just be careful and make sure that you get approval before 1/1/05, UHC is talking about excluding all as a whole. I'm praying this thought away from them! Terri