Trying to get approved for gastric bypass

I am hoping to get approved for gastric bypass. My insurance policy, United Healthcare Choice, does have an exclusion... "Health Services and associated expenses for the surgical and non surgical, medical treatment of obesity (including morbid obesity) are excluded." I called my insurance company, United Healthcare. I told them that inspite of the exclsion, I wanted to pursue the matter further. They told me to have my doctor send a 'pre-determination' letter along with my records. I have two doctors that are behind me getting this surgery and both would be willing to write letters for me. I have the usual comorbidities... diabetes, starting to have back problems, losing cartilage in the knees, etc. But I have another health problem that is not a result of my being obese, that I hope will help in getting this approved. I have psoriasis AND psoriatic arthritis. It is an auto-immune disease like rheumatoid arthritis. My main treatment for it is Remicade, which is done by infusion, every 8 weeks. The treatment goes by your weight. So, the bill for each treatment is very expensive. The last one was $10,000. The reason it is so expensive, is that it takes 6 months to make one vial. Anyway, needless to say, if I had the gastric bypass, (forget about my health) the treatment cost would decrease considerably. I guess I am grasping at straws here, hoping there might be something in my specific situation that will help me get the surgery. Is there any hope for me? Robbi

Hey, you are speaking their language with the cost benefit analysis. Crunching the numbers to show how many months at your goal weight would pay back the money for the surgery might be a compelling argument. Good luck! Caryl

A lot of people get appproved if it's medically Necessary.

I use Enbrel for my psoriasis weekly...it's a self injectable that I do myself. have you looked in to it? it is effective for the PA also.