Needing help with United Healthcare(bariatric surgery exclusion)

leahmoody
on 9/10/13 3:24 am - Hattiesburg, MS

Has united healthcare ever paid for any type of bariatric surgery? I think it is a specific exclusion on my policy. But I was wondering will they pay for the cost surrounding the surgery such as the facility fee and the other things and I just pay for the cost of the actual procedure? Can this be done?I want and need this surgery really bad and can not afford to pay cash. Are there any charitable services that will help. I am desperate.,,,

leahmoody
on 9/10/13 4:06 am - Hattiesburg, MS

it specifically says Exclusion....Surgical and non-surgical treatment of obesity. Well could the doctors say it's a treatment for my chronic hypertension, degenerative knee problems, incontinence, and sleep apnea to get it approved without saying it's spefically for weightloss?

hollykim
on 9/11/13 11:44 am - Nashville, TN
Revision on 03/18/15
If there is an exclusion on your policy,then that means the company you work for did not purchase the rider for Wls. The insurance will not pay for something the company did not buy coverage for.

The surgeon has to put down a certain ICD code for the insurance. If he is doing a bariatric procedure he has to use a Bariatric code. There is no surgery for the co- morbidities you mention except wls so there is no surgical code for it. I doubt many surgeons would lie and defraud the insurance co in this way. They could lose their medical license for doing that.

Sorry to say,if it is excluded,it is totally excluded. There is an exclusion on my policy also,so I
Saved up and went to Mx. Best thing I have ever done in my life.

I do know at lowes and Starbucks both offer insurance to part time employees that includes Wls. Maybe you could get a part time job there?
GL

 


          

 

VSG on 06/12/13
Contact Walter Lindstroms office and fight it. I have UHC, and had to go through the entire appeals process. Mine wasn't excluded, but I had to appeal all the way to the employer. There are ways to win against an exclusion. It will take awhile, but some of the provisions of Obamacare already in place could work to your advantage here.

Laurie

   

Sleeved 6/12/13 - 100 pounds lost to get to goal!

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