Question:
UHC of FL EXCLUSION anyone approved? if so what to do?

My policy has an exclusion pertaining to treatment of obesity, surgical and non-surgical(including Morbid Obesity). Is there any way of getting around this exclusion, does "medically necessary" influence any when this is present? Please help me and others I know in the same plan going thru the same problem.    — [Anonymous] (posted on June 7, 2001)

June 7, 2001
If you go to a doctor whose practice consists solely of RNY patients... as in a Bariatric Center... they have such a pipeline to the insurance companies that they know EXACTLY how to get you approved. If you make calls to your insurance company and stir it up or go to a small practice where the doctors staff doesnt know how to fill out the paperwork properly to get you through, you are toast with an exclusion. What part of Florida are you from?
   — [Anonymous]

June 7, 2001
To anonymous, I'm having this problem in Miami.
   — [Anonymous]

June 7, 2001
Contact Dr. Carrasquillas office at Florida Medical Center in Fort Lauderdale. 954 739 5531 There are three surgeons in the practice...all are laparascopic surgeons who do all lap RNY. Their staff is expert at dealing with the insurance companies. Contacting their office is your best shot since they do so many of these procedures a month they have contacts at UHC.
   — [Anonymous]

June 11, 2001
I'm from Iowa and work in Wisconsin for a company out of Minn. It is one of largest employers in MN. They have an exclusion to WLS. I contacted my HR deptarment and they call Corp. They put a case worker on it and my company call the insurance company and asked that my file be reviewed by them for Med. Nes.... I was approved within hours after they reviewed my case. Never give up.
   — Keith N.

April 28, 2003
I too have UHC PPO and am currently waiting for approval which letter was sent in by my doctors office late last week. I called three times and first time they said not it was not (I have same exclusion) and the other two times I called they said yes if medically necessary and if pre-determination letter sent in by doctor. Please let me know if you were eventually approved. Tonya
   — Tonya D.

May 3, 2007
I am at this time having the same problem with UHC in Florida,I have contacted my HR with a request that she help me as I am a diabetic with an A1C level of 8.5, degenerative joint problem in the knee and sleeping problems, as well as, depression from the roller coaster ride of being able to have a quality life vs. a life cut short because of genetic diabetes and heart trouble. I have contact obesitylaw.com and was told that prior to me call, there was a new study linking the treatment of diabetes and gastric bypass within the last 30-60 days and that I may be able to fight thru them as well. I feel horrible that insurance companies have the right of simply deciding your fate.....I believe thatn everyone should have a right to a quality of life if they so choose and I believe that everyone should decide their own fate If anyone has any further info on UHC in Florida, I would appreciate an up-date... thank you lesley
   — lesleysolopdunn