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Hi,
I have worked for UHC for over 5 years now and am trying to find out more about appealing the WLS. In my plan it is not covered. They said I could appeal it. My doctor wrote a letter of appeal last week and I'm praying to get some good news. Has anyone here every appealed the WLS and actually gotten it covered? If so please tell me about it.
I'm considering switching insurance because my current insurance might not cover my insurance. What insurance do you have that doesn't require the six month weight management before surgery. I would especially like to hear from people under 40 BMI with no comorbidities.
your Pcp or surgeon needs to write you a letter for the IRS stating that the surgery was medically necessary and you had XYZ comorbidities that made it medically necessary.
Insurance has nothing to do with tax returns so that is not an issue.
Gl
on 1/24/14 5:16 am
How do you prove it was medically necessary? My doctor (2 of them) told me I would qualify for it being medically necessary but my BCBS plan covers NO obesity help. Does insurance denial or noncoverage impact tax deductions? It's so confusing.
Anyone has experience with HIP Prime HMO? How long does it usually take them to review the paperwork?
Anyone was denied? and if so why?
I know there is a section on the website where you can check out the feedback from others by insurance, however all the feedback is from 2002-2005.
I have the same insurance and have an appointment with the bariatric doctor in February. Did you get an answer to your question? Did you pursue the surgery? Hoping for information so I am prepared for my visit and have the appropriate level of information to support my case.
Thanks for your help!
I'm in PA and bought a BC/BS silver plan through the Healthcare.gov site. It's decent coverage and costs about 60% of what I previously paid for one of those junk plans that cover little to nothing. Like you, when I looked at all the plans available I saw that bariatric surgery is not covered by even the platinum plans. However, when I scrolled all the way down, I saw something about the possibility that BC/BS might pay for some aspects of WLS. I had originally thought I would buy a platinum plan, because when I first got a look at the available plans it looked like WLS would be covered. But now that it seems that not even the most expensive plans from either BC/BS or Aetna will cover WLS, I went with a less expensive plan that would cover my healthcare needs and figured I'd look to pay cash for WLS. I'm in the process of making a final decision about which surgeon I'll be going to in Mexico.
I've looked into financing and I haven't seen any especially attractive options online. However, many credit cards are offering very low interest rates for balance transfers -- some as low as 0% -- and you get that low rate for 12-15 months. That's long enough for me to be able to pay off my surgery while still covering all my regular expenses. A couple of my cards regularly send me those blank checks that can be used to pay off balances or whatever, and I always used to tear them up and throw them away. Then I decided to use one last year and basically got myself a substantial loan at 0% interest, with 15 months to repay before my regular interest rate goes back into effect. I am going to do the same thing to pay for WLS.
HTH.
Hi babygirlinokc I am in the same boat with BCBS Federal they state there is nothing that states that I was compliant with the previous surgery. The person who submits your paperwork has to be real careful with that issue. Best of luck!
I did not go well. After that I called the insurance company and they state the doc office is not submitting all information.