please help me to understand this...
Jennifer A.
on 9/5/03 7:13 pm - Henderson, TX
on 9/5/03 7:13 pm - Henderson, TX
my insurance through husbands job became effective on 9/1 but just got into the online system at uhc.
i have a policy book that states exclusions as being 'services or supplies for obesity, weight reduction, or dietary control, except when provided for morbid obesity'
when i logged on to check what the website said about my policy the only thing i could find about it said "Weight loss programs whether or not they are under medical supervision. Weight loss programs for medical reasons are also excluded."
PLEASE someone help me understand this!!! is surgery considered a weight loss PROGRAM?"
i have an apt for consult on mon and dont want to waste my $ on it if i know ahead of time that i have a wls exclusion.
PLEASE PLEASE email me with some insight.
im crying here.
Weight loss surgery is not a weight loss program...it is treatment for morbid obesity, which your plan should cover according to how the policy reads. You will need a lot of paperwork to go along with your request for surgery, which your surgeons office should have already informed you of. Most insurance companies require: medical evidence of prior doctor supervised weightloss attempts; a letter of medical necessity from your primary care physician; a letter from a psycholigist saying you are mentally aware of what you are about to undertake; a letter from a nutritionist or dietician saying you are aware that this is a life-changing operation and that you are aware that your dietary needs and restrictions will be completely different from what you're use to. Also, it helps to have a personal letter from you to the insurance company outlining why you need this surgery, including any medical problems you have like high blood pressure, diabetes, sleep apnea, etc. Enclosing specific material documenting weight loss attempts you've made in the past, whether it be use of OTC drugs or fad diets, the year you tried it, how long you stayed on it, how much you lost, how much you gained back, would also be good. Essentially, send them anything and everything that pertains to your past attempts at losing weight or medical problems you've had pertaining to being morbidly obese. You should give the paperwork to the surgeons office and let them submit the request for surgery. A good profile to check out for lots and lots of information is: http://www.obesityhelp.com/morbidobesity/profile.phtml?N=c1041989149