How do I handle conflicting info from insurance & exclusion?
My insurance is United HealthCare, Choice. When I initially contacted my insurance company and asked if weight loss surgery was covered under my plan, I was told that there was coverage for morbid obesity. I was recently denied because of an exclusion in my policy which states: "Health Services and associated expenses for the surgical treatment and non-surgical medical treatment of obesity are excluded." The wording in this exclusion does not say anything about morbid obesity. I called the insurance company again after I was denied and some of the reps. are still telling me that my plan will only cover morbid obesity, but not obesity. I was told to appeal, but I am not sure what to say in the appeal letter. I have my Certificate of Coverage, but it doesn't say anything about morbid obesity in the book, and I haven't been able to get anyone from the insurance company to give me anything in writing that states that morbid obesity is covered. Could you give me some advice?
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