United Healthcare choice

UHC has an exclusion to wls in our healthcare plan as of Oct 1st. I am so depressed as I have 110 lbs to loose. I got approval for psych visits and started everything for the visits to the surgeon and I was told by UHC customer support that wls had to be medically necessary. Now I am getting letters at home from UHC behavorial Health about my mental status and I keep getting surveys from them. I called and explained the psych eval was for bariatric surgery but I keep getting the letters anyway. My human resources person led me to believe the surgery would be covered if medically necessary but I received the new policy in the mail the end of Oct and I saw the exclusion. I called the wls doctor and was told it wouldn't do any good to appeal because of the exclusion. I have decided to make them pay anyway. I have psorasis arthritis and the only way to alleviate a lot of the pain is to lose weight or give myself enbril shots a couple of times a week. It will cost me $35. a month but it will cost UHC close to $4000. a month. That adds up to to $48000 a year. I think the wls is about $30000. With the 2 blood pressure meds I take a day and this arthritis med I can rack up some costs to UHC. Also I guess I can have the GERD problem fixed also. I am going to call the doctor tomorrow to start the enbril shots. If I can't get the wls at least I can lessen the pain of arthritis and be able to walk on the treadmill.BC

Correction. Enbrel will cost the insurance company about 15,000 a year for the rest of my life. Oh well 48,000 sounded better but that was a quotefrom merk-medco and they were wrong. Thanks, Betty

I am on the same plan. I am going to submit my paper work anyway. If I was you,I would write them a letter stating exactly what you wrote here. If they are about the money, they should take the surgery deal. If I do get a denial, I am going to Vocational rehab.