Well I'm new posting here and I'm crushed all in the same day.

Well it's official........I've been denied. I've been pretty quiet about things trying not to get my hopes up about my insurance covering WLS. But I can honestly say I am now crushed. I did everything I was supposed to do. I called my insurance months ago and was told it was not covered unless it was deemed a medical neccessity. I completed the application to OSU, blood work and written office notes from my PCP, the meeting with the dietitian and the psych evaluation. I got my stamp of approval from OSU as a candidate for the program and I can start the nutrition classes. But UHC choice plus says no go.......it's an exclusion. From what I understand and what OSU has explained it's a losing battle to appeal when it's a written exclusion. A suggestion was made to speak with my employer about getting an exception made for just me. I was told by OSU that this has been done and I could try with my HR people. I think it might be called a rider to my policy. So now I'm asking if anyone has gone through this and could lend some advice. I'm at such a loss now and don't know what to do. I just can't believe I have gotten this far and to have it end now is so sad. Thanks for listening and any help would be great. Kelly

Well kelly,I feel so badly for you. Try and get a loan from a bank and do self pay. It is worth every penny believe me. Just work hard to pay it back. It was the best investment I ever made. Good luck, Cindy

Kelly, I can tell you that people get exclusions overturned all the time. I'm not saying it's easy but it can be done. Don't give up yet! Dr. C

I totally feel ya hun i went threw all of that in may june 2003 went threw couple test payed 100 for initial appoinment at bariatric treatment centers all to be let down with a denial from insurance company an tried to over turn it my company actually had it wrote in that any procedure for wait lose was excluded i am now disabled on medicaid and it all starts over so best of luck

Kelly, Don't you dare give up, that is what the insurance co. is banking on. They have an appeal process for a reason. I also have UHC and they told me that all of their policys have an exclusion for WLS, unless it is medically needed. I had surgery Jan 31, 2005 and UHC paid for it 100%. Please don't give up!!! Tammy Toth

kelly-i don't have uhc but i agree with tammy---they (all ins companies)want you to go away--DON'T!!!!!! use your appeal process wisley....

oh yeah i agree i remember when i got denied my family doctor was actually pretty upset by it and he had said unfortuanlly insurance companies look at what will get they by for the next 2-3 years ( the average some has a certain company either buy switching or the company getting bought out by others) so to many of then they'd rather buy medication for 2 yrs then pay for an expensive surgery so keep at make them hate to answer the phone lol jk but you get my point