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kdsmiles

LAP-BAND Patients
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Everything posted by kdsmiles

  1. kdsmiles

    Insurance Exclusions

    I just wanted to clarify something that some may not know.... UHC usually is the best insurance to deal with regarding any WLS... The plans which have exclusions are not because UHC made that decision. It is because the EMPLOYER has chosen not to cover WLS... I switched jobs when I found out the new job had UHC. Because I went to several seminars and heard nothing but the best about UHC covering WLS... Talk about disappointing, when I finally got my new insurance with the new job. I waited 30days as the surgeon recommended, only to find out it was an exclusion on my policy...I also tried to fight it, but was told by an Executive at my company and UHC that the EMPLOYER sits down with UHC and makes a policy for it's employee's and chooses what will be covered and what will not....I was devastated and couldn't believe out of all the UHC policies, mine would have to be one that WLS was an exclusion. So I started another mission...To find another job in which WLS was covered before I accepted the job....Very tricky to do, since I didn't want the employer to know what my long term goal was, but I did it.... I am happy to say I started another new job and this insurance is also UHC, but the difference....WLS is covered when medically neceassary.... Fortunately, I am an RN and am able to have my choice of jobs since there is such a shortage of nurses. It was a pain to find out if the surgery was covered before I took the job, but I did it. All insurances need to treat this like the disease that it is and cover it all.... I just started my job March 27, 2006, needless to say, I have a ways to go before getting the surgery, but I am happy that my insurance does cover it. I will be able to have it at the hospital I work at here in Florida...I have done all my homework on this surgeon and have started the ball rolling as much as I can until I can go full force. My advice is don't try and appeal it. I know many who have and unfortunately they wasted their time. Before I switched jobs I too was looking at going to Mexico. It is true that there are several surgeon's who have been doing the bands longer than many here in the States...It is much cheaper and they can help you with financing too....Maybe you can look into it and see for yourself. They have coordinators you can talk to here in the States. They were very helpful to me and could help ease your mind....Best of luck to you, Kelli

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