I have United Healthcare and my particular policy excludes any surgery for obesity. I was hoping to have the bypass done, but since it is excluded…. I would have to pay for it out of pocket, and I cant afford that. I barely make enough to make my bills, none the less add a surgery. Can anyone tell me if they make exceptions to exclusions? Or is there a way to get around them? I really need this surgery if I want to be alive in another 10-15 years. I am submitting a letter of medical necessity from my doctor and a bariatric surgeon. I am can show a family history of comorbidities. I dont have any comobidites yet, but I will soon. My a1c is on the high end of normal. And my cholesterol is normal… but my ldl is on the high end of normal. I am getting a sleep study done to prove I have sleep apnea… but I dont know what else I can do. Any suggestions?
And in advance to those that will say go on a diet… I have been on dr supervised diets with no sucess.
I also know for a fact that they do cover this procedure on other policies. I have a friend who has UHC that had it done a year ago in March. Her coverage did not exclude it. So I know they do cover it if you have a certain policy. However, when I spoke with the guy who sold our company the insurance, he explained to me that exclusions are chosen by the company that buys the policy… which would be my employer. And while they were trying to keep down costs, they excluded it because since I work at a gym everyone else, besides me, is thin. So they never expected to have to use it… so why pay for coverage that they will never need? And while I understand that.. it is too late to change the policy… because then it would be a preexsisting condition… and still not covered.