ANYBODY HAVE UHC INSURANCE TO COVER REVISION?

Hello, I know I posted last week or so about IL BC/BS but after talking to the agent and trying to get an individual plan I was told I would be denied for pre-existing conditions and to not waste my time.

I called my HR lady and she told me that though our employer had a clause in our contract not to pay for WLS that I need to continue to fight it because she knows of some others that had it done because they were able to prove medical necessity and that after paying for the band out of my pocket and my health progressively getting worse that I need to pursue this.

So, I see my PCP doctor this week to set up my appt. to go to the University of Iowa Hospitals to see about getting a revision.

Has anybody had UHC and they paid for a revision??

What was their criteria you had to submit?

How long did it take??

I am just curious and wondering what I am up against.  Any help would be greatly appreciated.

Thank you.

UHC paid for my revision from VBG to RNY last year.  However the insurer isn't really the issue as much as the plan that your employer picked.  The employer is the one that decides whether or not to allow WLS related costs.  I'm not sure how much luck there would be in fighting an exclusion, but it's definitely worth a shot.

Debbi

I hear ya....but beings my HR lady is telling me to fight it...what the heck right?? I mean what more do I have to lose?? I already paid out the ass for this band that's causing me issues...so I might as well see where this yellow brick road leads me! :-D

If you don't mind me asking.....why did you revise from VBG to the RNY??  Did you have medical complications or something??

I don't mind at all. I had my VBG done in 1992 at the age of 19 and weight of 369.  I lost down to around 250ish and kept it off for about 4-5 years.  Didn't know it at the time, but my staple line disrupted and my pouch was open to my stomach.  I regained all the weight I had lost plus a whole lot more.  By 2007 I was 514lbs and wheelchair bound.  I finally decided that enough was enough and I'd give surgery a try again.  I thought that I had failed the surgery, and my habits did contribute to the weight regain, but the surgery also failed with the staple line disruption.  The only real "complications" I had from the VBG were frequent vomiting and weight regain.  Since I had already gone the restrictive only route I decided I needed the malabsorption as well this time.  So far so good, I'm 19 months out from my revision and down to 281.5 (that's 232.5 lost!!).  Still losing 4-8 lbs a month and looking at some plastics now.

Definitely try to fight it if you can.  It's worth a shot.  Good luck!  I've been reading about your difficulties on the other boards and I sure hope you can get them fixed. 

Debbi

Debbi,

thank you for your kind words or encouragement...they mean a lot.  I am going to fight this and I hope this brings me the resolution and answers I have been looking for and needing.  Maybe the sun will shine on this dog's ass sometime soon.  I can only hope!!

Again, thank you!!