United Health Care Illinois

SALEMKITTY · November 15, 2005

I am currently seeking the lap band procedure. I have been going to the doctor for over 6 months. My current insurance is Humana PPO, but my company is switching to United Health Care PPO in January 2006. I noticed they have an exclusion for surgery related to weight loss including surgery for the morbid. I contacted them and they said the surgery is excluded. Since I have already been under the doctor's care for 6 months isn't there some way to have this covered. My doctor is trying to get my blood pressure down before they submit the request for approval. My BMI is 40 and my blood pressure is hovering around 168 with medication. My doctor said it needs to be in the 130 range. So I think this is medically necessary. I am afraid I will have a heart attack before this gets approved.

Any responses would be greatly appreciated.

November 16, 2005

united health care of illinois may have the exclusion for surgery but your company may cover it. you should check with your HR dept. If you work for a large company there is a good chance the surgery is covered.

SALEMKITTY · November 16, 2005

Thanks for the reply.

Unfortunately, I work for a very small company but I will wait and see what happens. I plan to keep pursuing this until I am approved or I have to pay for it myself.

steve425c · November 17, 2005

If you have to pay yourself, it is covered by filing it on your income tax for the year, if it is medically nessesary

margie9852 · November 19, 2005

I have United Health Care PPO thru Caterpillar and I called and ask if they would cover the surgery and was told yes if it is for morbid obesity ,and there are medical factors involved ,,does anyone else have this insurance ,,I am in Illinois also,,,,,,,,,