Question:
I have Untied heal care EPO- WLS is listed as an exclusion.
Will I be wasting my time with writing up appeal letters and such? — Tracy B. (posted on January 17, 2002)
January 17, 2002
Hi,
I am assuming you mean United Healthcare PPO. I Have the same. In the
benefits book it looked like it wouldn't be covered. But when I called I
found out that if I qualified (BMI 40, or 35 with co-morbs) they would
cover it at 100% minus a $250 copay. I was approved in less than 2 weeks.
If they denied you the first time I would definately appeal. You can even
pay a lawyer to write the appeal (they may take you more seriously) if you
can afford it. Keep trying, it is worth it. Good Luck!
— [Anonymous]
January 24, 2002
For heavens sake at least try. What do you have to loose, other than a
bunch of weight. I have battled for almost a year to get this surgery, and
insurance companies want you to give up. But if you keep in their,
hopefully it will pay off in the long run. I am scheduled for Mar. 4, 2002.
— Dell H.
May 31, 2003
I also have UHC- EPO and due to the exclusion it was denied. I'm a little
disturbed by the comment the anoymous wrote on 1/02, because I would have
assumed the PPO was the same thing. I'm also angry with my employers for
allowing exclusion to be placed in the insurance policy, and I wonder what
can be done about it. When I applied for insurance, I didn't get a copy of
the plan summary, just the plan worksheet. I now have learned a valuable
lesson about reviewing insurance.
— Rae L.
Click Here to Return