oh no... UHC insurance I need help/information

Finally a call back from St Vincents today and they said my insurance said im excluded from surgery,,, NOOOOOOOOOO I called last week and they told me it was covered if medically necessary. So out came the policy today Under Personal Appearance section it says there is an exclusion for Weight Loss Programs, for medical and non medical reasons... I assumed that meant Optifast and Medifast to me those are programs but surgery is surgery.. Has anyone else had this problem with United health care choice plus?? If so please advise Thanks Stacy

UHC is a great insurer UNLESS your company has written in an exclusion. There is no way around that exclusion with UHC. Some folks report they have gone to their company and had the company "void" the rider on a one-to-one basis but I do not know how this works since my employer wasn't going to do it. Basically, (and I know not a lot of people can do this) I wrote the check for my surgery. UHC did pick up all blood work and first appt. with surgeon and all prescriptions. Good luck. Karen

Thanks Karen I contacted our human resource person today and asked him to check into the situation for me The exclusion says weight loss program not WLS but we will see. I wish I was in the situation to write the check and not have to go through the insurance hassle but I am not. I was at a company last year and they paid 10K cap on the surgery and I couldnt afford the difference so I cant afford to foot the whole bill either but thanks for the info and i will see what happens. Stacy

Stacy, I just had mine done at St. V. last week and I have UHC, but I have All Network - they paid 100%. I did have a sleep study done, which discovered severe sleep apnea, therefore - medically necessary (even though I did not have that exclusion in the policy). So, here's two suggestions: 1) if you have not had a sleep study, have one to see if you, as so many obese patients do, have any form of sleep apnea; 2) wait until October when you have to sign up for next year's insurance and explore if there is another UHC option that would allow the surgery. Just some thoughts. j.