I have Benefits administered by UMR, Which is Open access to Great West Healthcare. My companies Benefits summary state the following :
Gastric or intestinal bypasses.
• Charges for diagnostic services.
For surgical treatment of Morbid Obesity the patient must be:
• Twice his ideal weight;
• Demonstrate inability to control weight through diet over a minimum of a five-year period
documented by a Physician’s medical records; and
• Must suffer from a documented separate condition which is aggravated by obesity
I just had an RN from Greatwest tell me that it "looks" like my plicy only covers Gastric Bypass and not the lapband.. Should I contact my company administrator or appeal this.. It makes no sense that they would cover Gastric Bypass and NOT the lap band.. Any advice would be much appreciated..
