WTH? I am so confused! UHC SUCKS....
So, I was in contact with my health insurance company last summer and was informed that bariatric surgery IS covered. I began the "hoop jumping" to reach the point of being ready for my surgery (lap-band). The surgeons office submitted the required paperwork for prior approval a couple weeks ago - and UHC DENIED me! Stating that it isn't a covered service. WTH???? I am devastated, heart-broken, confused.... but mostly ANGERY! When did they decide that it was no longer covered? Aren't they required to notify people when the policy changes? I have already sent in my appeal paperwork whi*****ludes the email, from a UHC rep. stating that it IS covered. i am not sure if it will help. Has anyone had a similar experience? Anything anyone could contribute as far as coming out with a positive result during the appeals process would be GREATLY appreciated!
Thanks,
Nicki
Thanks,
Nicki
Nicki,
Some policies exclude certain things that your employer doesnt want to pay the extra premiums for. But when you contacted UHC they should have taken a look at your policy to see if there was such an exclusion. If you have the email that you were sent by the UHC rep then I believe they should cover it because you were given faulty information. The insurance company I work for makes concessions when someone is given blatantly wrong information. Hopefully this will be the case with yours!!
If your appeal fails you may want to contact your Insurance Commisioners office and explain the case to them, they may push UHC to give you the coverage. No garauntees though, and it may be a tough battle but its one you may want to fight in order to get what you need.
Hope this helps!!!
Some policies exclude certain things that your employer doesnt want to pay the extra premiums for. But when you contacted UHC they should have taken a look at your policy to see if there was such an exclusion. If you have the email that you were sent by the UHC rep then I believe they should cover it because you were given faulty information. The insurance company I work for makes concessions when someone is given blatantly wrong information. Hopefully this will be the case with yours!!
If your appeal fails you may want to contact your Insurance Commisioners office and explain the case to them, they may push UHC to give you the coverage. No garauntees though, and it may be a tough battle but its one you may want to fight in order to get what you need.
Hope this helps!!!
Thanks! Yes, that does help! I did include copies of the email with my appeal paperwork. Obviously, my hope is that they cover my lap-band surgery without any more problems. I also wonder if maybe they only cover gastric bypass or something like that .... I guess if that is the case, I will have the bypass instead of the band. THANKS for the heads-up with the Insurance commissioner --- I didn't know sich a person existed. I assumed that if my appeal was denied, I would have to get a lawyer involved.
Still frustrated - but I have crossed my fingers again,
Nicki
Still frustrated - but I have crossed my fingers again,
Nicki