Written Exclusion..Help

I currently have United HealthCare Insurance with a written exclusion in my policy for weight loss surgery. I just wanted some feedback on others experiencing or that have experienced a written exclusion on their policy. Where any of your attempts successful at getting this exclusion "overturned"? Does anyone have any suggestions on how I might approach their pre-determination department when I decide to submit a letter to them? I am desperate to have this surgery but I do not have the means to pay for it nor the credit to obtain a loan for it. Does anyone have any other suggestions that might help me to get this "ball" rolling? Thanks for any support you can offer me. : )

Yes, I had UHC. In my policy it stated there was no coverage for weight programs or WLS. When I first read that I was ready to give up. But I made my Dr. appt. and they told me that UHC was easy to work with. I did all the pre-op testing with the Drs. UHC paid for all my tests. Then they sent it in to UHC it went to a Nurse Coordinator and it was approved in 3 days. B/c of my other medical conditons. Everytime I called to get benefit info about WLS they just told me it wasn't covered. So don't let the written exclusion stop you. I didn't have to do an appeal or anything. I just got an approval letter. Had my surgery on 12-14-05. I started the process April 2005, but I had been trying to have the surgery since 2003. I hope this helps. Let your doctors office file first. You have to get the denial letter before you can appeal. So keep the faith and just send it in.

WOW! you just gave me hope!! My company is switching to UHC in April and I was devistated! (because of the written exclusion)...maybe I CAN work with them........wish me luck!!

i don't know of anyone having a written exclusion with UHC. They have always paid for everybody I know that had surgery with them. My dr office said they are the best to work with. Go get em girl

Hi, I have a written exclusion thru UHC, Choice Plus, It's been over 14 months and I'm still appealing the denials, with high hoped but little faith. I can't afford this surgery out of pocket, it's my only chance..I have ALL kinds of health issues and documentation, referral letters, pictures, I'm set and would be approved if not for the exclusion, what I don't understand is that someone replied to me about having the exact same Insurance and was approved. I have talked to our HR dept. but they say it's the employer who asked for the exclusion for the cheaper Insurance, but I have asked to add a rider for like special cir****tances and gladly pay the difference, still no one will address me. Also the employer is telling me that it's UHC that won't offer to lift the exclusion, I think I'm getting the run around...any suggestions??? I'm exhausting all my avenues fast, I am in such poor health, my own appeal letter puts me in tears....Sincerely, Sheila

Hi Sheila, My heart goes out to you. I'm with you girl. My old job had the same thing, a written exclusion added on. I contacted bc/bs and they told me the only way to remove the rider was for tlhe employer to remove it and the yearly renewal time. My boss wouldn't, so I said fine. I'll be poor for a year and pull out my profit sharing money and go to Mexico and get it done that way. There are many ways to get it financed if you have the credit. I have too much right now so I can't get it done with credit. I have five kids and had them in private school so I'm broke. I'm even home schooling the two youngest for a couple years to help save a little. I wish you well and good luck. If you ever need anything just email me. I truly mean I have been as desperate as you are right now. I've been doing this for nearly four years now.