how can they say its not covered!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

hello everyone , its been a few months but i got turned down .they tell me that my husbands ins. will not cover the surg.even though i have high blood pressure ,high surgar, problems with feet ,and sleep apnea. he has united health care hmo thur state of georgia prison system........ HELP!!! DR. Henderson office staff told me to find out who or where the choses are made as to what is not covered . the ins comp. told me they did not know how or why that the st. of ga. did not cover this surg. has anyone here found a way around this ...

I'm not absolutely sure about this, but I think United Healthcare (State) has an exclusion in the policy. I believe several people switched to Blue Cross/Blue Shield of Georgia (state health benefits). BCBS does cover the surgery, I have it. Also, my hubby has United Healthcare thru Harland Business Solutions and it covered it also. So there has to be an exclusion in the state policy. Good Luck!! Smooches Chandra Lap RNY 6/22/04 -15 lbs

Aimee, hello and sorry to hear that your having such a hard time with the insurance company. They are good for wanting to get your money but they do not want you to take theirs! I did have some problems with my insurance carrier. I made them send me a copy of the policy. IF you do not have one get it! If you do see if it does have the exclusion. If you can not find it then notify the ins commissioner! I had to get his help with my case and finally got my surgery approved! Dr. Henderson is a great physician and I think you ll be so happy with them! Let me know if I can help you! I hope this gives you a boost and keep your head up! Its worth it! Take care and God Bless you! Kerri

Hopefully your doctor is not going directly through benefits but they are goign through the Care Coordinator. I have united healthcare and my job does not cover the wls, however i had to have my claim submitted through the united healthcare care coordinator and i was approve first try....Check and make sure they are submitting it correctly. I know if you just go through benefits, they will tell you no ,its not covered. But its also what rules the company has set up...Good Luck..and DONT GIVE UP...APPEAL AS MUCH AS YOU CAN..