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My Insurance doesnt cover WLS but......

By santos91, March 29, 2016 in PRE-Operation Weight Loss Surgery Q&A

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santos91 1

Posted April 7, 2016

So right now im waiting to go to a seminar.

Well before anything i called my insurance united healthcare to make sure they cover WLS. Well the lady says my plan does not cover any kind of weightloss program including WLS. She did tell me if i pay my deductible they will cover 80% and id have to pay the 20%. Also i did ask the lady if there was any requirements(6month diet plan) i had to do to be able to get approved & she told me no. All i have to do is pay my deductible and 20%. I really hope she is right. Insurance is so hard to understand sometimes. I just dont understand how my insurance doesnt cover WLS but if i pay my deductible they will cover 80%. How is that?

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So most insurance will list these surgeries as not covered. However, if something is medically necessary and your Dr's can provide proof of that then you can submit for an authorization to get it done. Your surgeon would submit your medical history and outline why you need this. There's usually a standalone department that consists of nurses and Dr's that will then verify if you do qualify for the surgery. If denied you can appeal, twice I believe with most. I work insurance and I've seen things not covered, paid out by the insurance. Best of luck with it all.
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Thank you guys.

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