Insurance Questions...I really need some advice.

Geminii37
on 12/15/07 1:04 pm - Carthage, MO

HELLO!! My name is Michelle and I really could use the expertise of many of you on this site. I have looked through many pages of posts and do not see what I am looking for, so here goes... I have two policies...My husbands policy which is employer funded and is requiring a 3 year mandatory time on the plan before it would be covered...which right now I would have a year ond a half to go....Then I have insurance with AT&T through United Healthcare which on that plan it is "not covered" per the lady at UHC. My question or problem is this~I cannot wait the year and a half health wise. I am 6' tall, BMI is 55 with MANY co morbidities and at 37 I don't want my health to decline anymore which it certainly will by 2009. So, is there a way to get around either situation?? Either by fighting the company funded policy or UHC which is stating "Not Covered"?? I was told that it actually might be easier to fight UHC than the company funded plan, and that there is attorney's who I could hire for a flat rate to do so. Any would be greatly appreciated. Thanks so Much ~ Michelle in Carthage, MO.

Jan C.
on 12/15/07 1:53 pm - Cedar Creek, MO

RNY on 08/14/06

Michelle i wish i knew the answer to your question. but i dont, there is a forum on OH that does deal with insurance questions and such not real sure where but it is on here. I know there are a lot of people on the Missouri board too that has or do dea with insurance daily and they may be able to help you some. UHC has been the insurance of some that have had the surguery . As a person that has had the surgery and the difference it has made in my life at my age I do know that if i were 37 and needing this i would do what ever i had to do to make the money to have it done one way or the other. It is that life changing. I would and did even think of going to Mexico and was getting things lined up to do that when Medicare came thru. bless your heart i know you feel like you are at the end of your rope but dont give up. If if is alright i will be praying for you that God will help us in this. Be sure and stay connected to the Mo. Board so we can all rack our brains and see what we can come up with. Love and hugs. Jan

http://community.webshots.com/user/mimicook?vhost=community

GOD BLESS YOU TODAY
JAN COOK

mallrat
on 12/15/07 10:03 pm - St Peters, MO

Revision on 08/18/10

Hi Michelle, I am also an AT&T employee who has United Healthcare. I had lapband surgery in Septiember 2006 and it was fully covered. I know RNY is also covered. I know a lot of other employees who have had weight loss surgery and never had any problem getting approved. I think the person you spoke with at United Healthcare was misinformed. I would think all employees would be under the same plan. Feel free to send me a PM with any questions.

Bec M.
on 12/16/07 12:49 am

RNY on 09/22/08

Hi Michelle, While I am certainly no expert.... I too have UHC but not with AT&T. I have been struggling in one way or another with approval since February and am still not approved. My advise for you is... if you have not looked at your employers printed copy of benefits, do that for sure. You might get a different answer on the phone each time you call UHC. I have found in my experience the phone conversations are not reliable, and alot of the time the people you talk to do not know their business... the surgeons office I am working with now confirms this, I wish I had known more before... it would have saved me months and months of waisted time. My husbands company has a website that lists all the benefits, I printed it out as proof of coverage. If you have not looked into that, you might want to start there as apposed to the phone calls, at this point. Also be sure you are documenting: day, time, person, and information each time you talk to someone... it may or may not help in the future. I know this is extremely frustrating, but hang in there... there just might be an answer yet! bec

cotonmom2
on 12/18/07 2:05 am - Wichita , KS

RNY on 01/21/08

If you need an attorney check out obesitylaw.com I have heard that they can help with getting you an approval. There is also a forum on here under insurance help. Good luck to you. Bev~

Bonzo63366
on 12/22/07 5:55 am - Ofallon, MO

RNY on 07/14/08

You will get nowhere with United Health Care. I have had the Missouri Department of Insurance go after them and my reply was. We do not look at any of your medical problems because you have an exclusion stating we will not provide coverage for morbid Obesity or morbid obesity surgery. In other words they should be car insurance providers instead. I pay $111.80 each month for people to kill me. Isn't that wonderful.

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Insurance Questions...I really need some advice.