UHC/

[Guest guest]

,

United Healthcare gave me a hard time, too. You must go through the

appeals process and then to your insurance commissioner.. I did here

in Florida, and the State of Florida is making them pay for mine. Be

warned, they flat out LIED to me and the state about this same thing..

they said they stopped approving the procedure in February 2001, yet

there were still posts from others with approvals after that. You

need to talk to some people who have had this procedure done with a

BMI of less than 50. (Establish Historical Precedence) Mine was 51

but barely and only just prior to surgery. I still had to get the

state involved and once that was done they were compliant. I think

they do this to test your resolve and commitment. They have to pay

MUCH more for DS (and even more so in my case since I had to go out of

network) than the RNY.. DO NOT SETTLE FOR ANYTHING LESS THAN YOU FEEL

IS RIGHT FOR YOU!!! Dont let them get away with 'cheaping out' on you.

And dont feel bad for costing them money. I saw on CNN the other

night where UHC had strong profits.. even in the face of the stock

market falling and our terrorist activity. So be persistent, read

your certificate of coverage.. it will come down to how much you want

it done and how smart you are. Research your rights in your state..

they have to abide by your state law in order to sell policies there.

Good luck!!

Sue

Post op 9/11/01

Dr. Warden

Ocean Sps, MS

> I have been going round and round with my insurance. Now they are

> saying that they will only approve the DS for people with a BMI over

> 50. I have a 46 or so. My benefit page says that m.o. is covered

if

> medically necessary. The Rny is covered with BMI of 40. It seems

to

> me they are just pulling excuses of from nowhere to try and stall

> until April when they remove the benefit from all plans - statewide.

> (United Healthcare) When I asked where in my policy it stated the DS

> was reserved for people with a BMI >50, they said no where, it is

> just an administrative thing. What should I do?

> Thanks,