Healthpartners

Hello!

I'm fairly new to OH, and I'm searching desperately for someone who might have some insight to give. Backstory: I've wanted WLS for a long time. I called about a year and a half ago one of the surgery centers to inquire about it. When I told them where I worked they wouldn't even allow me to come in for a seminar. They said that there was no way my insurance would cover it, and unless I self paid I would not be able to have the surgery. Well fast forward to now, I still have my same job, but lost my insurance with them due to reducing my hours so that my kids didn't have to be in daycare. 

I now have Heathpartners through the marketplace. I had gotten very excited about this because I had thought that since MA and MNCare patients have it covered my independent plan would too. No such luck. However I've heard people say that even if Healthpartners says that they won't cover WLS people have been able to appeal and get it covered. I'm willing to fight hard if I have to because I feel that this is the right tool for me. Having PCOS makes it very challenging to lose weight, and I really have tried very hard. 

What I was hoping for is some first had accounts of people with Healthpartners that were able to successfully appeal even though the insurance said no. Theres a part of this website that lists all the insurance and people who have been able to be covered, and they say it was excluded and they still were able to get the surgery, but no information on how they fought it. 

Thanks!

Hello

Our hearts go out to you and all you are going through.  Here are some suggestions....  Post on our Insurance, Cash Pay and Financing forum.  This is where members have gone to discuss how to fight insurance companies and get approval.

I did a search for Healthpartners and found some posts.  Take a look and maybe they will help.  

http://www.obesityhelp.com/search/action,search_oh/?q=Health partners+insurance&cx=000946886326336472648%3Ae-vpeg4uyxw&co f=FORID%3A9  

Here is some information OH has put together to help with your appeal.  

Please keep us posted

Hi there-

I have HealthPartners insurance and they whole-heartedly supported my decision to have WLS.  However, I have coverage through my employer, but I can't imagine that would make a difference as compared to you purchasing HP though the marketplace.  HP has a great program that they have you go through prior to getting approved for surgery and I would really call and talk through your questions and ask why they would not offer coverage to you.

Good luck!

Thank you for the replies! I have been looking throgh the resources that you pointed me towards. I especially appreciate the appeals information! 

Midwestmommy, do you know if your policy through your employer allows for WLS?

Belle-

Yes, my employer does allow it.  I just had mine back in May.  Like I mentioned, I would call HealthPartners and try and get more details.  I can't imagine that they wouldn't cover it...it's strange you said they wouldn't.