Rider on husbands insurance says no WLS covered

HI, I am new to this site and don't know if this question has already been adressed.  My husband has United Healthcare Choice Plus.  When I called to see if bariatric surgery was covered they told me that on the rider it says no WLS was covered.  They also said something about obesity, but I wasn't listening good enough at that point.  I think they said that nothing for obesity was covered.  Has this happened to anyone else and if so what kind of appeal did you make?  Anything would help.  Thanks

If your husbands employer chose not to add weight loss surgery to be a covered benefit then unfortunatally they will not cover it under any cir****tance.  Its not the insurance company its your husbands employer.   Call your husbands human resources office and talk to them, ask them if they would consider adding it the next time the policy is up for renewal you never know, they just might listen. 

I have Dr Mandelbaum and got to know the girls in the insurance department very well while going through the approval process.  Call Nancy and ask her for advise, she wont' mind at all answering any questions you might have.

Jeannie

When my husband worked for Indiana State University, they did, and still do I hear, specifically exclude wls. I don't think they are required to cover it yet in this state. The employer can chose to not cover it. You would have to talk to the employer about it, not the insurance. I had to wait until I got my own job with insurance that did cover it.

Did you get a copy of your policy?  I know my insurance told me the same thing until I told them what page to look on of my policy which said it was covered.  If you didn't get one ask your HR dept for one.

Frankie

My husband's Company had the same 'fine print', I fought them for a year and a half, plus they evan refused to talk to me about changing their policy evan when I sent them records of how much $ I had cost them over the past 20 years for Obesity Related Meds and Surgeries!  So I had to get a few credit cards, cash out my 401K on a Medical Necessity (only 10% penalty instead of 25% , and you can have them hold out the taxes) and also use all of our savings, my cost for RNY was 27,000!  Good Luck to you.  By the way...................havn't regretted it yet!  Nor has my husband!

My husband's policy was my primary insurance when I started researching WLS.  We own our own business but we COULD NOT add that to our policy.  Believe me, I checked!   So not all companies can update their policy.    I also am employed but never carried insurance through my work.  I waited til open enrollment (after checking to be sure I would get coverage for WLS on it) and enrolled and was approved.   However, they said I didn't have enough co-morbities.   Went back to the dr and we went over the list and he proved each one of them.  Faxed it all over the my surgeon's office and on the third try, was approved.  I had kept my insurance through my employer for 3 years.  This year, however, they changed to a MSA and that's what we have through our business.  So I cannot contribute to both.  I dropped the coverage at my work.  Now my husband and I are concerned that they will not continue to cover my yearly office visits to my surgeon and if I have any complications , they will not cover them or the hospitalizations.  We never really thought it through.

If you work somewhere, I would look into that insurance.  See if they cover WLS and if you can enroll at open enrollment time.    I would have never had it if I hadn't!

Blessings,

Lois K