Question:
Has anyone gotton an override of an exclucion with United Health Care...
Please let me know, very down about this. I was approved last year but then I got pregnant and I had to put it on hold and this year now they are telling me they have an exclusion. :0( — J L. (posted on August 10, 2004)
August 9, 2004
No, I tried and tried. I had to wait until my company had open enrollment
and switch to a different Ins. company.
Tom
LAP RNY 9/23/03 341/192 -149
— Tom Barton
August 10, 2004
I also had no luck. Ended up going to Mexico for surgery. Now I'm
fighting them for reconstructive surgery. They think that losing 250 lbs
and having skin (rashes and sores) and back issues isn't medically their
issue... go figure! Good luck to you though. Try talking to your HR
department. See if they will amend their policy to INCLUDE it!
— SMG I.
August 10, 2004
My company had an exclusion clause and I hired Walter and Kelley Lindstrom
from Obesitylaw.com and they were awesome. My company must now cover most
of my surgery...best money I ever spent and they weren't expensive and have
a payment plan so no one is turned away. They will tell you almost
immediately if they can or cannot help you once you send them your
insurance information. Good luck and if you need more information, just
email me! Jennifer
— jenniferw
August 10, 2004
I did. Hubby's employer had Cigna HMO when I got my referral, and then
before I could meet with a surgeon, they announced they were changing
plans, to UHC HMO/EPO. I was told that the surgery was covered (the
booklets weren't available yet), under the new plan and to see the surgeon
anyways. I did and that was covered but the surgery was denied because of
an exclusion. Come to find out, it really wasn't a covered benefit.
I ended up dealing with the director of Human Resources at hubby's work,
who assisted me with the paperwork. Because I was already in the process
of seeking treatment prior to the change, they "grandfathered" me
in even though it was an exclusion under the new health plan. I and my
surgeon completed "Continuation of Benefits" forms that HR had to
approve, which they did, and all was covered.
If you have proof of your previous approval, I would go to your HR director
and ask them if they can extend this benefit to you still. It's worth a
try for sure!
Good luck, Shannon
— M. Me
August 11, 2004
That exclusion clause is something you will learn to look for each time you
sign up for a different insurance plan. My company switched back to a plan
that did not have the exclusion, but I ended up using my husband's plan.
— Anna M.
Click Here to Return