"Exclusion" -- is there any hope?

Hi, I have to first say that I am so happy to have discovered this site!  My wife and I have both been obese since childhood, and we are both considering surgery.  I am 32 years old, BMI = 47, known comorbidies include significant sleep apnea, shortness of breath, joint pain, and severe GERD that was corrected in '09 by hiatal hernia surgery.  It is clear that my obesity is affecting my health.

However, I have United Health Care Choice Plus, and "Surgical and non-surgical treatment of obesity" is bluntly listed in the exclusion section of my pollicy.  I called the customer service line and was told bariatric surgery was excluded an there was nothing I could do.  Does this mean a definite "no, don't even bother," or is this where letters from doctors, etc. can help?

Thanks a lot!
Mark

Welcome, you'll find a lot of support on this site. I can't actually give you an answer to your dilemma, but i can advise you to post your question on the forum of the surgery you want to have. Those people have already gone through what you are going through now, and I'm sure that someone can help you.

Great, thanks a lot!

Hi Mark, I am actually in the same position as you. In fact, I have the same exact coverage/plan as you. I asked customer service about the appeals process and she said to send letters from yourself and doctors to the address on the back of your ID card with attn to appeals. I am still feeling pretty defeated about it though.

Hi there, thanks for your advice.  I'm definitely pulling for you and let me know the outcome.  As was suggested above, I reposted this question in the Roux-en-Y forum and got many responses...all of which were discouraging, however.  They all said that "exclusion" means no chance of coverage no matter what you do.  Apparently your EMPLOYER has the say as to whether or not WLS is covered or excluded, and since premiums are cheaper without it, most exclude it.  Sounds like the only option is to talk with your employer and convince them to cover it next year when the pollicy renews or to self-insure and shop for a pollicy that includes WLS.  As for me, I will be the new owner of my company in 15 months, so I'll have the fortunate priveledge of hand-choosing the pollicy when it's renewal time.  You can bet I won't exclude it!

Hang in there!
Mark

Exclusion means exclusion - no ifs, ands or butts about it.  Was told this by my family doctor who is on the medical review board and by the insurance coordinator in my surgeon's office. 

Ask your surgeon if they discount if you pay out of pocket.

Actually I'm in the process now. I have appealed this last time through my husbands union,because his company isnt covering it was excluded out of the plan as weell. You ever heard of" kill them with kindness"? That will get on their nerves,I think they got tired of me calling every month,but I sent them a letter,mypulmilogist,cardiologist, and PCP doc sent letters,so we shall see what happens next.Its in Gods hands now.I wish the best to you.

I am in the very same exact situation. I am starting to research Mexico, but I wonder if I do that, will they refuse to cover any potential problems post-op. SO frustrated!!