ok i need help from everyone - ThinnerTimes

sierrab · 09-16-2006, 09:08 AM

ok as alot of you guys know my insureance has a direct exclusion to wls in it well my mom was talking to my sergeons office and they said these comps cover it in wa state
aetna
cigna
united health
my quesion is does enyone know out of these who is the easyest to get it coverage and what are all of there requirements to get coverd ? ie what are there hoops our insurance broker was talking about switching us to united health also dr fox's office said it may be possible to put a rider on our existing plan to cover it also

LyndasRoom · 09-16-2006, 10:38 AM

Christina,
It sounds like you and your family are talking to the right people. If I remember right, your parents have their own company, the insurance people will be your best advisors, but it sounds like the rider may be the answer!

tandy42 · 09-16-2006, 02:58 PM

hi, i have unitedhealthcare choice plus. the only hoop i had was my bmi being over 40 of course i also had diabetes and high blood pressure. my surgeon required the phsy. and dietician. but the insurance picked up the tab. i am in texas so not sure what they may do in other states.i would make sure you to read all the fine print.good luck in your journey.

sierrab · 09-17-2006, 09:11 AM

so tammy what your saying is all united required was a

bmi over 40
a therapist consalt
a visit to dietian

so no 6 month supervised diet ?

tandy42 · 09-17-2006, 12:50 PM

all i had to have was the bmi over 40. the doctor required the phys. evaluation and the dietician. but i would suggest that you check to make sure that unitedhealthcare will be that simple for your area. i know that the policies are differnt for each employer. but i didn't have the 6 mo. diet.

brittany · 09-19-2006, 04:58 PM

I am pretty sure that if it is an exclusion then they will not cover. It has to do with your employer not the insurance company. I started the process 4 years ago with united HC and was turned down I had doctors and test and bmi and sleepstudy, 3 co-morbities. I was still turned down because it was an exclusion. I lost that job a few years later and went to work somewhere else where they had united hc. I called in to uhc and talked to someone and they told me it was not an exclusion. All i had to do is have a bmi over 35 and mine was higher than that. No test no letters no nothing I had my approval letter in 2 1/2 weeks surgery 3 weeks after that. I also in desperation checked individual plans and could not find one that covered wls. Good luck to you I know how you feel I wanted it for 4 years and I was lead to the palce to work that coverd it.

notsosmall619 · 09-19-2006, 05:12 PM

that suckes!!