Insurance Company Information

I was wondering if there is anybody out there who has United Healthcare Insurance (Select Plus), in Wisconson, with the exclusion for any type of help with obesity or weight loss, but was still able to get approved for surgery (RNY-Open or Lap) ?

Hi Jill, I am wondering if you are talking about one of the county's healthcare plans?? That is what I had once from Waukesha County, and I met with the representative from UHC who told me it would never be covered, even with an appeal, because it was an exclusion. I was heartbroken until I realized the county offered another plan, Compcare Blue. And they will cover the surgery after 5 criteria are met. So I switched insurances at open enrollment last year, and here I am 5 months out and have a surgery date!! They were so easy to deal with, took only 9 days for an approval letter to arrive in my mail! I would be happy to tell you more if you would like, but to answer your question, I think it would be highly unlikely that UHC of Wisconsin would approve the surgery, even if it is medically necessary. I know other UHC plans do approve it by reading some of the information on the website, but for some reason Wisconsin does not. That needs to change!! Hope that helps! Traci ([email protected])

Hi Jill, I, too, have the problem with United Healthcare Insurance (Premire). The exclusion reads, "Surgical treatment and non-surgical treatment of obesity (including morbid obesity.)" I've contacted my human resources person and they are considering a change of plans in October. She knows of 2 people in our organization that had the surgery before we changed from BCBS last October. One had to rush to get into surgery just before that contract expired. I've talked with both of them and they are so happy with the results of the surgery. I don't know that we have any recourse with something so explicitely written. Carol (or Waitin' for October!)