Can a UHC exclusion be overturned on apeal

[bigez1 0]

Hello

I was wondering if anyone with UHC has ever gotten thru a policy exclusion for any weight lost surgery.

I am sure I can show need, I am 6'4" and over 450 lbs, my BMI is over 54, I have borderline High Blood pressure, a family history of diabetis and heart problems., and an artificial hip.

Tony

[faithmd 14]

I hope Alexandra will chime in but from what I understand a true exclusion in a policy to all weight loss surgery is not something you can get past. You can't overturn it, it wasn't a denial, it's an exclusion in the policy. Now if they will pay for bypass but not adjustable gastric banding, then you may be able to get that overturned. But not a policy exclusion.

[Lady Q T 0]

Hi Tony, When was you denied? I was denied last year by UHC, so when 07 came around I picked up my ins. at work BCBS (UHC was thru my Husband job). So when I was going thru to get approved by my ins. the Dr. office also sent UHC paper work too and low and behold UHC approved me before my own ins did.

Hello

I was wondering if anyone with UHC has ever gotten thru a policy exclusion for any weight lost surgery.

I am sure I can show need, I am 6'4" and over 450 lbs, my BMI is over 54, I have borderline High Blood pressure, a family history of diabetis and heart problems., and an artificial hip.

Tony