Help needed....

angeldavis
on 5/17/06 4:57 am - Birmingham, AL
I was told by my insurance company United Healthcare Choice Plus(EPO) prior to attending the weight loss seminar here @ MCE that Dr. Miles was an approved Bariatric Surgeon under my insurance. I was also told by UHC that WLS whi*****luded Lap Band Surgery was covered if deemed medically necessarily. Taking that information and going to the WLS, I scheduled my consultation. I paid my upfront consultation fees in which I know will be reimbursed, because the doctor office just received payment from UHC. Okay, Dr. Miles received my PCP clearance letter, and all medical records information that would put me as a candidate for WLS. Now all of this occurred on May 2nd. All of a sudden I was told today by United Healthcare that under my employer policy, all WLS of any kind is excluded. I asked the representative after going through all of that, why am I now being told that it is not covered. I did thoroughly explain to her that they gave me a specific bariatric surgeon and advised me all information above. She told me that even if I appealed it to them, it would still be denied, because they are not allowed to step outside of their boundaries on a policy that my employer selected. She told me to contact my human resource department for my job and explain to them that I was misinformed and try to appeal to the human resource dept. with my company. I am hurt, because I spent money I had saved just for this, because I researched before even making the first step to contact UHC for WLS coverage. Does anyone have any ideas on what I should do? If they have ever known anyone or have gone through this type of situation? If this doesn't work does anyone know if financing is a good thing to do? Please help!!!!!!! Thanks, Angel
DocsLadee
on 5/17/06 4:38 pm - Nikiski, AK
this same thing happened to me - my husband's employer did not purchase the portion of the health insurance policy that covers gastric bypass surgery - I have been also told there is nothing I can do unless the company changes insurance companies or purchase the policy - I have written letters to the CEO of my husband's company which took a lot of guts - mental anguish admitting to strangers I need surgery because I am fat ! I do not know what state you live in but I live in Alaska and I found a state program that may help me but I need to convince the board they need to cover this surgery - here is my post - please write a letter - let them feel your pain and anticipation of being healthy again - Need YOUR HELP - PLEASE EVERYONE I am having major insurance problems - but I may have found a solution that would help me and others - Alaska has this program that might cover gastric bypass surgery but the board of directors need a little nudge - please write a letter and e-mail it to : [email protected] - she is the lady at The Alaska Comprehensive Health Insurance Association (ACHIA) is a nonprofit organization created by state statute to provide health insurance to Alaska residents who are denied health insurance in the private market because of medical condition. Check out their website www.achia.com - please I need a lot of people to write letters explaining your co-morbidities and how gastric bypass surgery has taken away some of your ailments and how healthy you are now - need to list all the benefits of having the surgery and all of the negative things that can happen without this surgery - PLEASE I am begging these letters need to be in by July 30th - Thank you. [email protected]
angeldavis
on 5/17/06 10:43 pm - Birmingham, AL
Hello, I become so hurt to know that many of us are having trouble with insurance paying for something that we really need to continue long lifes. I am not in Alaska, I am at the near bottom of the United States in Alabama. I would love to assist with a petition, but unfortunately with me not residing in your State I won't be of any help. Angel
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