Been excluded and had it approved?

[Ashley B 1]

Has anyone's insurance excluded them from WLS, but then had it approved later? I'm in this situation with United. Need some hope, even if it's slim!!

[makemyownluck 785]

If you have group coverage, typically the exclusion is at the request of the plan administrator (your employer) to lower their premium costs. While the exclusion is active on your plan, it's not possible to get this covered. However, you can talk to your HR manager and see if they would consider a plan that has this coverage. Or see if they offer another plan that doesn't have the exclusion.

Good luck!

[KatInFL 216]

Has anyone's insurance excluded them from WLS, but then had it approved later? I'm in this situation with United. Need some hope, even if it's slim!!

I wish you luck! I had an exclusion and was told by my HR and insurance company that under no circumstances will they cover it. It was a decision made by my company when they purchased the plan, to make the premiums less expensive for themselves and their employees.

I ended up paying out of pocket and going to Mexico and am so glad I did!

~Kat

[Ashley B 1]

Thanks girls for replying. My insurance told me I can send letters and they will review them to possibly cover it. It is a shot in the dark, but I'm going to give it a try.

[lyndeeboo 68]

I wanted to wish you luck!!!

[makemyownluck 785]

Thanks girls for replying. My insurance told me I can send letters and they will review them to possibly cover it. It is a shot in the dark' date=' but I'm going to give it a try.[/quote']

Good luck. Let us know how it goes!

[Kristina J. 581]

Yeah, it really depends on what they mean by "excluded." For my insurance there is a contractual exclusion for bariatrics that states in no very clear terms that they will not cover bariatrics in any situation. So it's self pay for me! If they say that they could possibly approve it with letters and appeals then perhaps it's not a total exclusion! Good luck!!

[caitiebug 26]

Mine told me it was included when I started the process. I just finished and submitted my paperwork to find out it was excluded. My Dr says they can't do that because its a misquote of benefits so I'm hoping that appeal will be positive.