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.




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