Question:
What is the next step when appeal is denied?

My company is United Health Care Choice Plus. They have an exclusion clause that says the following is excluded: "medical or surgical treatment for obesity or for reducing or controlling weight, unless otherwise specified in the covered services provision." The covered services provision discusses medical necessity. My appeal letter discussed the differences between obesity and morbid obesity (since that wording was not used) and discussed my reasons for medical necessity. I was told over the phone that is was not a covered benefit. When I told her that the clause does not address morbid obesity, she stated that there is only one obesity. What should I do know? I have already contacted the Attorney General's office. Would it do any good to write another appeal letter.    — Jackie L. (posted on January 23, 2001)

January 23, 2001
Make sure that anything you send is mailed return recept requested. Keep records of any conversations you have with the insurance company. I to am fighting UHC, and it's not looking to good. Unless the department of insurance can find a way around this all hope for me is lost. If I can help you in any way please let me know.
   — richter454