Is it is excluded from your policy, do you have any hope?

allykat · January 17, 2008

I have UHC and thought I was all set. I called with the procedure codes and was told it was covered 90% with approval after predetermination from doctor. I was psyched!

After reading about another State of GA's problems on this website, I decided to call back and verify. This person was great, but she said it was excluded from our policy and that it would not be covered. She did say I could gather documentation and appeal it, as I would any uncovered claim. I could also file an appeal before treatment to avoid uncovered expenses.

So my question is - do I have a prayer? Is there any hope? Without insurance coverage, I know I cannot afford this - there is no way. I cannot afford to finance this and have no clue how I could get this otherwise. Any advice from BTDT folks?

minpinmom · January 19, 2008

allycat, there is hope. I went through the same thing - I started 3 years ago, went through all sorts of hoops then realized Lapband was excluded. I felt horrible. I kept doing research and trying to find ways to pay for it. This past December, the policy changed and it is now a covered surgery. Keep the hope - and appeal - I have heard of all sorts of people getting the surgery only through extensive appeals.

Good Luck.