RachaelThomas

Aww thanks girl!! I just now saw this. I love that fact that we met on here and have become such good friends. I know that I can count on you for support and vice/versa... I am so thankful for Bariatric Pal. It is going to make this whole process alot easier!!!!

I currently have UHC Community Plan of Ohio and I am having trouble figuring out what the requirements are. I have called the insurance company several times myself and all I can be told is medically necessary and that I have to do the 6 month diet. My PCP and Surgeons office called and thats all they were told, medically necessary, and a 6month diet. I have been going to a weight loss program since July and I have completed all of the requirements on their end and the surgeons end. I just have to meet a few more times with the dietitian and nut and pcp to complete my 6 months. My last weigh in is in December. After that, they will submit an approval for the surgeon. BUT is it really going to be that easy? I feel like I am going to get a denial. I have a BMI of 45. I have no real comorbidities. I have gerd, pcos, depression, plantar fascitis, and hip problems. I just feel like because this is a medicaid plan, it is not going to be covered. I hope that I have not been going through this whole process since July for nothing. I finally emailed these questions this morning to my insurance company hoping to finally get an answer in writing. Any information that anyone has would be great.

What hoops? Don't scare me. All I was told was a diet and a letter from my doctor. Were you denied initially?

Congrats! That is wonderful news!! We will be submitting in less than a week. Hopefully I will be joining you!! I am getting so nervous!!!

I have UHC Community Plan of Ohio and my last appointment is Nov the 13th. It will be my Psy evaluation. Once I complete that, they will be submitting for approval for the surgeon that. Originally, we thought I would have to do the 6 month diet but last week I was informed it was infact only 3 consecutive months (which would be 4 total weigh ins ) and so instead of having to wait til the beginning of the new year to submit I should have an answer before then. Yay!! Apparently the standard UHC plan requires 6 months but the Community plan here was different. Its crazy to think I am almost finished. This has been a long process for sure. I have no comorbidities but I have a BMI of 45 and I am hoping that will be enough. Hopefully I didnt go through this whole process for nothing. I was told to prepare myself for a denial initially because alot of people do not appeal and fight it. This is a major surgery. I am most definitely starting to get anxious!!! Once that is submitted it can take up to 2 weeks to hear something back from UHC. It is going to be a long month!!! But I shall remain positive!!! Best of luck to you!

Congrats on a surgery date!! That's so exciting.

I have UHC but it is a medicaid plan so that might be why our stuff is different. I am also a resident of Ohio. I just hope that it works out for you as well. Don't worry about buggin them. I will be right there along with you as soon as I can get my info submitted. I am sure that they will be sick of me before I can get a final answer. LOL I am not sure about the whole letter thing but both the surgeon and my doctor have to write notes for me.. anyways good luck!! hopefully we know something soon!

I have UHC and yesterday I found out I do not have to complete the 6 month diet ( I only had nov and dec left). Apparently, there was some miscommunication and certain UHC plans make you do the 6 month diet and so that is what they have had me doing since July. BUT my plan did not require that so I spoke with the insurance woman at the weight loss center and I was told to come back for my psy clearance on the 13th. Once I am finished with that, they will be submitting all the info the same day. She told me I have completed all of their requirements and the surgeons requirements. She has all of my medical records and I am good to go. I was told that I need a medical necessity letter from my PCP. I stopped by her office and talked to her yesterday and she will have that letter ready to go by next week. I heard it can take up to 2 weeks to hear something back. I am gettin nervous! Good Luck to you!!