Question???

I will have Unitied Health Care...they have an exclusion against WLS is this a definite No?....and also if I do decide to fight it (if i would need to), and get a Lawyer is it going to cost me as much as the surgery would if I did self pay (which I can't)...Thanks for the help...Kim

UHC has a very strong exclusion in thier policies. The have to because of the way their approvals differ from other insurance companies. They leave the decision of medical necesity up to the doctors, not them. And they do not require referrals. This means that in all acuality that if you do not have an exlusion for WLS in your policy, you really don't need to get approval from UHC. Most do to save their butt, but you don't have to. If you have an exclusion in your UHC policy, there is almost no chance in it getting overturned. The only time I have seen anything get exception is if the policy was self funded and the employer allowed the one time exception. I've never seen it on WLS, just other procedures. And it's VERY RARE. It probalby wont cost you as much in lawyer fees because they already know it's most likely not possible to over turn it and won't take it on.