there hope for me? HELP

I have United HealthCare Choice Plus and #10 under exclusions is Surgical and non-surgical treatment of obestiy including morid obestiy. OK, well TECHNICALLY I am SUPER OBESE......so my question is "Does that mean there could be hope to get WLS?" Since I'm not in the exclusion. Cindy

Cindy, I am fighting my insurance company regarding an exclusion as well. Mine is worded differently. I will be praying for you. It never hurts to request and appeal and appeal and appeal based on medical necessity. Good luck! Beth

Cindy, Is there hope? It depends... Are you self insured through your employer? Are you a valuable employee? Do you have life threatening comorbidities? If your employer is self insured, you do have a shot. After all, they can choose to pay what they want to. If you are fully insured, check with your State's Insurance Commissioner. There may be laws that force the insurance company to treat obesity as any other disease. Fight the good fight! Roberta

How do you know if they are self-insured or if you are fully insured. I am a teacher for a school district.

Cindy, If your company is self-funded they are not held to the same ERISA appeal process as a fully-funded insurance. A self-funded insurance program looks to exclude many proceedure in order to "save" money. We all know that in the long run obesity costs far outweigh the surgery costs, however they do not always recognize this. You are not entitled to an outside peer review under a self-funded insurance and may be shot down by the second appeal. It is the choice of the administrator, and very difficult at best to get overturned. I have yet to encounter anyone who has overturned a self-funded exclusion.

have you got approved yet i was wondering because i have the same health care and exclusion.