Question:
Has anyone had any luck with these types of exclusions?

I just found out today that our insurance company United Healthcare Options PPO has 2 exclusions one that states "Weight loss programs whether or not they are under medical supervision. Weight loss programs for medical reasons are also excluded." and "Surgical and non-surgical treatment of obesity, including morbid obesity." Has anyone had any luck with these types of exclusions. I noticed that they didn't have any exclusions for the treatments of under weight, bulemic, or anorexic people; shouldn't this be considered discrimination? I also wonder if anyone who is diebetic and has been denied, have you tried to argue that WLS can treat or get rid of diebetic symptoms and use this arguement as the sole basis for getting the WLS? Please any information would be helpful. Thanks, Beth    — Beth B. (posted on March 30, 2004)

March 30, 2004
bETH! GOOD LUCK i TRIED FOR TWO YEARS WITH UHC AND NO LUCK. AT ONE POINT THEY TOLD ME IT WAS COVERED AND THEN WHEN I STARTED THE PROCESS THEY CAME BACK AND SAID IT WASN'T. i CAN'T TELL YOU THE LET DOWN FEELING THAT WAS. I AM SUPER MORBIDLY OBESE WITH MANY CO-MORBIDITIES AND STILL COULD GET THEM TO COVER. I SAY IF THEY TELL YOU YES GET IT IN WRITING! THEY HAVE TOLD ME YES TO OTHER THINGS AND AFTER I HAD PROCEDURES DONE THEY DENIED COVERAGE AND I HAD TO PAY! GOOD LUCK, CATHY
   — CATHYSDAN

March 30, 2004
You need to talk to a lawyer and see where you stand, theyre always changing the rules during the race. We won my exclusion at the State level. try gary www.obesitylawyers.com
   — superellen

March 30, 2004
Hi Beth, I tried to fight an exclusion from UHC Options PPO. My work had the exclusion. I was told by one that it was covered then told differently. I contacted the LINDSTROMS. I actually sent in my check for $800 and after she viewed my case and saw it was UHC she called me and told me she didn't have luck in the past with my same circumstance and returned my money immediately. ( the actual check). I wound up having the surgery under my husbands insurance and the UHC did pay for some of the hospitalization and some other stuff. It is worth contacting a lawyer like the LIndstroms. They are honest and very nice.
   — Mary E.

March 31, 2004
That is UHC's iron clad standard exclusion. They will not pay for WLS under this policy. Period. Don't waste your money on a lawer, that money would be better spent finding another policy. Rebecca Perkins former UHC employee.. :)
   — RebeccaP

April 2, 2004
UHC will not give in. However, see if your company is self-insured. If they are, your employer is making the decision to have the exclusion. UHC brings their insurance offers to the table and the employer picks what they want. If your employer is self-insured, you could ask them to make an exception. I have been through all of this. Sadly, my employer said "no" to the exception. It is so frustration!! Hope things work out better for you. I am working on trying to get my employer to change their minds on the surgery. Maybe someday!
   — Terry Lynn W.