New member, frustrated...need advice

I have been doing lots of homework on weight loss surgery and I'm in the process of exploring my options.  Though I have United Health Care, I was REALLY disappointed and saddened to learn this morning that my plan does not cover anything weight loss related, procedures or anything, even including those related to morbid obesity.

So now what? 

:(

There is no way for me to pay out of pocket for this surgery......

Is it becaus eof your company?  Have you asked for documentation for YOUR policy, including all riders/exclusions?

Sounds sketchy that NOTHING is covered.  Don't go by one person you talked to on the phone.  Make sure it's the policy that explicitly covers you - with all riders and exclusions.

Some employers add exclusions or do not pick up WLS riders so reduce costs.  You can ask your HR department to help you get the info you need. 

Another option is to look at becoming self-insured for a year - and make sure it includes those options.

If you have a spouse, investigate their insurance.  While you may have to wait to get on that policy, it might be worth it.

Saving money via Flexible spending accounts is another way to pay (pre-tax) for the procedures....

Look at going to Mexico as an option.

Also, Cleveland clinic is constantly doing studies about conditions that can be corrected via WLS - contact them and see if you qualify for any.  STAMPEDE is one - it's to show how WLS "cures" diabetes and researching why....

The WLS exclusion has to be from your company, not UHC as they covered my sleeve with no problem.

Exactly...while UHC is a network provider for lots of bariatric centers locally, anything related to the treatment of obesity (including morbid obesity) is not covered..under my particular plan.  They said it on the phone, I saw it on the website, I read it in my plan documents.  It's an exclusion on my policy?  Sounds crappy.  It is.  But is it the truth?  You betcha.

BUT.  Good news.  No, GREAT news.  While we are in the midst of open enrollment here at my job, my husband's employer is also in their open enrollment period.  And after doing some research yesterday, his insurance now seems like the more attractive option.  He is a federal civilian employee and I was thrilled to learn they completely cover the surgery, with the exception of a $100 surgery fee!!

Hurray for you!

See, there's ALWAYS a way around - sometimes you just have to look for it or work at it....

Soon you'll be a loser like the rest of us!  Congrats!

CONGRATULATIONS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! On finding a way to have the WLS... I've had not one seconds regret.... It saved my life... I'm happier and healthier than I've been in all of my adult life.  I'm preparing for my 3rd childhood when I attain my goal weight!!!!

 I have Uniter Healthcare. I had bariatric surgery 2 years ago.
It depends on your situation and what OTHER health problems are a problem because of the weight loss?
 
I had severe malnutrition and vitamin deficiency so I had a revision.

Dont get sad until you lost a good fight, and unfortunately you will have to fight for it.

It is AMAZING to me that any insurance plan could "exclude" paying for WLS.... How can they be so ignorant??? It would save them 10's of 1000's of $$$$ if the covered individual is morbidly obese!!! Heart problems, hypertension... DIABETES.. Just the savings on diabetes treatment alone would save the insurance companies millions of dollars! 

Now that I've vented.... I had United Health Care Insurance when I had my RNY and am still covered by that company... Don't take one person's word.. Check it out like the person suggested.  A have also seen people's postings here that spoke of a program at the Cleveland Clinic where WLS surgery was being studied as a cure for type 2 diabetes. Perhaps you could get involved with that.  Good Luck... Don't give up.... You will find a way to get it done.

Mick DeWine
[email protected]