United says NO!!

Helen T.
on 5/28/03 12:38 pm - Irving, TX
I have worked for my company for over 4 years. 2 other employees have had the gastric bypass surgery and was paid for through the company insurance. One in 2001 was paid through Aetna, and the one in 2002 was paid through United. In August of 2002 the company announce changes in premiums, co-pays, and max outs. We were told there would be NO policy changes. I waited a year to get an appointment with the surgeon just for the initial consultation. Saw the Dr. Feb. 2003. Approved by the doctor, and denied by United in less than a week. I have gone through both appeal processes and talked to everybody up to and including the VP of Benefits for our company. I am being told that due to the fact that our insurance is NOT self-funded, my employer cannot override the policy. United tells me that the client write the policy and they cannot override the client. I feel the that I am being taken for a ride!! I had a benefits specialist tell me that the employer decided that not enough employees will benefit from the Obesity Surgery to add it to the cost of the plan. If anybody has any suggestions or ideas how I can get this approved or paid for through another source, PLEASE LET ME KNOW. I checked into paying my self and was told that it would cost $30,000. to $40,000 dollar. (Not in my life time would I have that kind of money) Thank you,
ERICA H.
on 5/30/03 8:19 am - Houston, TX
Please consult with Walter Lindstrom (obesity surgeon), there might be a chance of him helping. Maybe since the employer is actually the one who will not help, you can look at it from the standpoint of them discriminating against you for being obese..i mean they don't exclude gallbladder surgery i am sure, why this life saving surgery....seek assistance from the attorney just to see what he says
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