insurance exlusions

I'm a 911 dispatcher in Indiana....our current insurance is United Healthcare.  I'm wanting to
have the surgery...i'm approx 5'9" 286 lbs bmi is about 42.  I was exicted when I found out our insurance was going to be United Healthcare because that is the insurance that my mom has, and she had the surgery a year ago with absolutely great results...I call the insurance co only to find out that my employer has an exclusion on anything to do with weightloss surgery or obesity.  Any suggestions?

I am so sorry to hear about the exclusions. From what I have heard, there is nothing you can do if they have exclusions writthen in the policy. Self pay, I believe would be your only option or swith Insurances when its time to redo your insurance.
Good Luck.
Shanna

You can try and ask your employer to change to include it in the insurance package they offer you. It's basically up to your employer on whether or not they want to include it or not, So ..... go ask an HR person if tthe company would be willing to change it or not. 

 

Good Luck & Blessings

Jodi 

I believe there is a State Law in Indy that requires companies to have at least one insurance coverage plan that includes Bariatric Surgery.  I remember reading about this about 18 months ago.  I would do some research, find out the law on that and then go to your employer.

Your now walking in the shoes that I have been walking in for the past 1 1/2 yrs.  My husbands company also has an exclusion on WLS.  Didn't do a bit of good to get them to try and change their policy, their a small co of around 150 employees and have a 'self insured policy'. Evan though my husband has worked for them for 33 years!  If they changed and included WLS then everyones premimus would go way up!  Went that route, got declined twice with the insurance co evan though I had 10 different  Dr.'s Referals and a BMI of 57 with Sleep Apnea, Arthritus, Knee Problems, High BP, and Gallstones!  In researching Indiana Law, no luck there either, on exclusions being against the law.  I evan wrote Gov. Mitch Daniels last month and got this response. If the company is a Federal Run Company (which is what my husband's is-Chevy Dealership) there is nothing that can be done to change it.....but if it is a State Run Company, then the Governer's office will get involved.  Heard that they got 4 people WLS from a factory here in Lafayette that had an exclusion in their policy.  So now I am trying to put together $25,000 to self pay.  Need to find another loan for $5000 and I can get it scheduled. Going to St. Vincents in the am and talk to the Financial Person and try to get all my ducks in a row!  Good Luck on your quest!

So did you email Gov. Daniels or did you just send a letter thru the mail...just curious where I would need to go to get an address.  I find out from our HR person that our insurance is "fully insured" which means that it's governed by the state insurance commision.  I'm so aggravated cause I want this soooo bad.  My mom had the surgery a little over a year ago and looks/feels great.  I want to be like that myself...go to a store buy the "trendy" clothes.  I would love to be able to self pay but there is just no way I can afford that.  I'm still researching and trying to find out if there is anything that I can do.  Any ore suggestions would be great.

I emailed the Governors  Office and got a reply back within a week.  Good Luck!

Ok, so today I contacted my insurance company which is United Healthcare.  I had other business with them to begin with but while I had them on the phone I asked about anything to do with weight loss/ weight loss surgery.  United Healthcare confirmed again that anything to do with weight loss/ weight loss surgery is not covered due to an exclusion by my employer. I asked if it mattered if it was medically necessary.  She told me that I had the option of asking my HR person if they would consider covering it if it's medically necessary...(which i'm sure they won't).  Unfortunately, I'm fed up with my HR person...I had someone call and find out if our insurance was self funded or fully insured...she says fully insured.  Well, I asked the insurance company today and they say that ours is self funded...so I beleive that our HR person doesn't know anything about our insurance.  So that's where i'm at now....I'm getting soooo frustrated.  I don't understand how an employer would want to hamper someone's ability of getting better or trying to better themselves for their future.  But thanks for the info on the gov's office...don't think it will help me now.

I dont know anything about your insurance issue, but just wanted to introduce myself and welcome you.  I am an EMT in the Muncie area. So we have a little in common.  I hope you can find some sort of loop hole in your insurance.  Dont give up!

Sorry it's taken me so long to get back...thanks for stopping in.  I was an emt for almost 8 yrs and went thru paramedic school but never took my test...stupid I know.  But the stuff I learned prior as an emt helps alot in my job now.