UHC
Under the heading shown below, you will see the exact wording of my UHC company policy. I'm guessing this is an exclusion but I'm not sure. I have a 54.6 BMI so I'm hoping I stand a chance... I included the cosmetic surgery part only because I'm wondering if that could be used to cover the surgery since, apparently, cosmetic surgery IS covered if it DOES improve or restore some physiological function--which, this surgery would certainly do . So, please look over these policy highlights and tell me what you think. Do I stand a good chance for coverage based on my policy? Or would I do better not to waste either my time or theirs??? MEDICAL SERVICES NOT COVERED UNDER ANY COVERAGE OPTION The services and supplies listed in this section are Noncovered Medical Services under all of the Coverage Options. The Medical Plan does not pay for them even if a Provider recommends or prescribes them or they are the only available treatment for your condition.
Obesity ¡ Services and supplies for the surgical, nonsurgical and drug therapy treatment of obesity and morbid obesity.
Cosmetic/Physical Appearance ¡ Cosmetic procedures and items that change or improve physical appearance without significantly improving physiological function;
¡ Procedures that correct a Congenital Anomaly without improving or restoring physiological function;
¡ Surgery or other procedures to relieve the psychological consequences or socially avoidant behavior that results from Injury, Illness or Congenital Anomaly;
(The next section I copied from the 'definitions' portion of the policy)
Noncovered Medical Services Materials and services that are not considered Covered Medical Services and for which the Medical Plan does not pay even if a Provider recommends or prescribes them. They include but are not limited to the materials and services that are listed in Medical Services Not Covered Under Any Coverage Options in this Medical Plan Summary.
Hockeymom87 · 0 replies · 605 views
