BDutchess

Finding so much great info here, thank you everyone.

I also have UHC and found out today that WLS is excluded from our company policy. I contacted the clinic my GP suggested, they are the ones who contacted the insurance company. (They don't see patients first, they contact the insurance first before even seeing you. Is that normal?). When I asked about possibly appealing the decision (since my BMI is 48 and I have comorbidities) they said their experience is that when there is an exclusion, the insurance won't pay period and the only option I have is the cash option which they quoted me 16-18K for a sleeve, 22-24K for bypass. I guess I'm naturally suspicious when 'things don't make sense', and I'm wondering if this clinic deliberately didn't want to appeal because they would rather have patients who don't have that exclusion on their policy or was he correct in saying if there is that exclusion, no way the insurance will pay?? Should I try again but with a larger hospital in my area (Houston) like Hermann Memorial or Methodist who have special bariatric programs rather than a specialized clinic like the one I contacted? Love to hear thoughts about this since it's all new to me and I'm trying to get the help I need.