United Healthcare with exclusion

I have United Healthcare Choice Plus plan and our group policy has a written exclusion for gastric bypass. I have spoken with two of the UHC patient care coordinators and have been told that on my policy, even with the exclusion they approve 97-98% of patients that file.  At a pre-surgical seminar the nurse told me to call again to be sure before I go through with the expense of the consultation, evaluations, etc. I called today and spoke with someone in the benefits department. He told me that they would not cover it since it was excluded, but that I could go ahead and file pre-authorization to show medical necessity. I had called their customer service last week and was told that it was excluded and wouldn't be covered under any cir****tances. So, out of talking with 4 people, I have 2 that have said 97-98% covered, 1 that says it would not be considered at all, and 1 that essentially said it is excluded but try anyway (sounded like it could be covered if proven medically necessary). I think they're just giving me the run-around to try to discourage me from trying (thus sparing them the expense). Has anyone with UHC Choice Plus plan been approved for surgery despite an exclusion? If so, were you approved the first time or on appeal, and what were your co-morbidities and BMI? Thank you!

I, too, have UHC with an employer exclusion. I plan on going forward no matter what and will be happy to relate my experience.

I have United Healthcare but my job didn't have any exclusions. I got approved in 1 day through United Healthcare. I would try if I were you. It couldn't hurt!

I too am attempting to have a bariatric surgery for morbid obesity authorized by UHC. My husbands employer also has an exclusion on his policy for "any morbid obesity treatment". My surgeon did the preop appointment and sent it in and I received a denial of benefits letter. I am in the process of filing an appeal, any suggestions?  I would love the opportunity to put our heads together. You could email me at [email protected] or reply via this message. I hope to hear from you soon. Sincerely,  Crystal Boyet

Hello from another newbie!  I am in the same boat and have just started the process and will be attending seminar on 13th and then calling for an appointment.  Hoping to hear from someone who's gone through this particular process with UHC as well. Good luck and please let me know how you make out. Regards, Deborah

I have UHC POS and there is a written exclusion. Has anyone been able to get bariatric surgery covered under this plan? I'm desperate and cannot afford the cost of the surgery. I've already asked my employer to add the benefit to the plan. NO response of course. PLEASE ADVISE. Thank you!