Question:
I have recently read that United Healthcare will stop covering WLS as of 3-15-02.

Has anyone else heard that?? I have UHC Choice + policy.    — MaryBeth R. (posted on March 4, 2002)

March 3, 2002
I don't have a specific answer to your question but I do have sort of a general one. Recently our support group went through a widespread panic because one of our members received notification that WLS was no longer going to be covered by BCBS and she shared this info with the group. Fortunately for us we have a few BCBS employees in our group who explained that it's very rare - almost unheard of - for insurance companies to discontinue coverage across the board. Usually any discontinuation of coverage is policy specific. For example your particular policy may stop covering WLS but all United Health Care policies probably won't stop covering it. Our support group member's BCBS policy was discontinuing coverage for WLS but our other member's policies weren't discontinuing coverage. It's my understanding that any discontinuation of coverage can only occur at renewal also - they can't just stop covering things midstream. Our BCBS folks told us to contact the customer service number that's usually on the back of the insurance card and ask this specific question "Does my policy cover gastric bypass surgery which has been deemed medically necessary for the treatment of morbid obesity? If so, do you anticipate that this coverage will change or cease within the next 12 months?" Supposedly if you ask it word for word just like this it eliminates the possibility of misinformation from your insurance company because of a loop hole. (for example they will tell you that surgery to treat obesity is not covered but will fail to tell you that surgery to treat "morbid" obesity is, etc.) Good Luck to you and remember that NO doesn't always mean NO!
   — ronascott

March 3, 2002
I hope not. I have surgery scheduled for 3/21/02. I am sure this is a misunderstaanding. Contact your carrier directly.
   — Ann O.

March 4, 2002
I have United Health Care and when I called them this morning to check on the progress of my approval they told me that they are no longer covering WLS as an ELECTIVE surgery. I told her that I'm certainly not electing to have this surgery, I need this surgery - it is medically necessary and the more tests I have done, the more potentially life-threatening problems we're finding. I also told her that I had called them three times before chaning to UHC in January and that I was told as long as it was medically necessary then it was covered. I told her that changing to UHC had become extremely expensive as I was with an HMO before and this is a comprehensive plan. This is beginning to sound like a breach of contract situation if they don't have it in writing that it is an exclusion but then make it one. I agree with Rona, I don't believe they can do this across the board but you know they'll try anything to hang on to every red cent.
   — Vicki H.

March 4, 2002
Have you already requested approval for the surgery? If so, they may not be able to deny you based on a change that takes place after your paperwork was submitted to the insurance company. I would press them, get a supervisor on the phone, and ask for the change in writing. Specifically ask if the new exclusion applies to surgeries that were requested before the exclusion took effect. Good luck.
   — Mariee H.

March 4, 2002
I had wls .. open RNY in Dec 2000 , a revision due to a sld in April 2001, and another revision due to an atonic pouch Feb 2002.. We are insured by UHC.. Options PPO.. they have covered all three of my surgeries .. I was approved within 2 weeks each time.. This is the first I have heard of this.. We have a bill in GA congress that if enacted would prevent insurance providers from discriminating against obesity surgical treatments..
   — Gina Landers