denial due to exclusion appealing

Well I was denied by UHC due to an exclusion in my policy so I am appealing it because my exclusion states "weight reduction/control" it said nothing about morbid obesity or gastric bypass. My question is, that I recently found out that my husbands company is actually self insured and that I can only appeal one time through UHC so if UHC denies my appeal what are my chances when it comes to appealing throught he actual company has anyone ever dealt with anything like this??? If you have any info please respond to me any info is better than nothing!!! Thanks!!!

Appeal your little heart out. Read your benefit booklet for appeals procedures. It should tell you who the Plan Fiduciary is, and who the Plan Claims administer is (UHC). Fight the good fight! Roberta

This lawyer can sometimes help with exclusions. You might want to tell him your situation and see if he thinks there is something you can do. Gary J. Viscio, Esq. Resnikoff & Viscio, PC 145 Willis Avenue Mineola, New York 11501 (516) 742-5300 Fax (516) 742-8130 [email protected]