United Health Care

September 6, 2005

I was reading my plan documents for united healthcare and it says under exclusions....

"Health service and associated expenses for the surgical treatment and non-surgical, medical treatment of obesity (including morbid obesity) are excluded."

Does anyone know a way around this?

Thanks,

Kerry

ajack · September 7, 2005

I dont think that excludes the surgery. I have united and they pd mine.

ReneBean · September 7, 2005

Are you sure it doesn't say EXcluding Morbid Obesity? That is how most policies read. Normal Obesity treatment is not covered - but MORBID OBESITY treatment is.

Alexandra · September 7, 2005

Kerry, that sounds like your employer has permitted the standard exclusionary language to remain. It's possible there is a rider elsewhere in your documents that overrides this language. I hope so, at any rate. If there's nothing in your employer's deal or in your state regulations that countermands that language, you may be out of luck. That's a very clear exclusion.

September 8, 2005

Thanks for the advice. It does actually say "including morbid obesity". I'm thinking about going to a doctor anyway and seeing if they can get it covered.

I work for a medical school. You would think they would cover it.

Kerry

DrHekier · September 11, 2005

In our practice we have learned (the hard way) that even within the same insurance company, individual employers can add exclusions to policies.

It's frustrating for our office to hear an exasperated patient tell us "but my friend has the same insurance I have and she got them to pay for the Band."

Even with the same carrier, your individual employer can add an exclusion to the plan to exclude WLS. You would think a medical school would not do that but both hospitals in our town exclude treatment for obesity surgery.