santos91

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? Sent from my SM-G530T using the BariatricPal App

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. Sent from my SM-G935T using the BariatricPal App Thank you guys. Sent from my SM-G530T using BariatricPal mobile app

East Tennessee here. Knoxville! Sent from my SM-G530T using the BariatricPal App

What exactly should i say when i call back? Maybe its me asking my question wrong idk. I just ask them if my policy covers weight loss surgery. Sent from my SM-G530T using the BariatricPal App

Thank you kmorri. I will let the doctors office know what the insurance people said. I didnt think it made sense either, what the lady was saying. I hate dealing with insurance. Ugh thank you everybody. Sent from my SM-G530T using the BariatricPal App

I get insurance through my husband's work company. Sent from my SM-G530T using the BariatricPal App

Thank you @@J.lynn The way u explained it makes better sense. I guess they didnt explain it correctly or something. Pretty much all she said was "no your policy doesnt cover WLS or any kind of weight loss program but if you pay your deductible($2000) then we will cover 80% and then i would pay the other 20%. I was just like ok thanks and hung up....i guess i will have to see what happens after the seminar. Sent from my SM-G530T using the BariatricPal App

The insurance lady did say something about benefits but i couldnt quite understand her because my phone was breaking up. I think maybe she said " let me see the benefits of WLS" im not sure though , i could be wrong. Sent from my SM-G530T using the BariatricPal App

I have united health care insurance through my husbands work company. I am going to a seminar April 7th. The thing that sucks is i called united health care & they do not cover WLS :-( but im sorta confused (either that or im just slow). Insurance is so difficult to understand. Insurance said they dont cover any weightloss programs or surgeries but she said if i pay my deductible they will cover 80% and then i pay 20%. It sounds good i just hope i do not have to do a 6 month diet plan or whatever. I did ask the insurance lady if there was a criteria i had to meet before getting approved (example: 6month diet) & she told me no....so i guess we will see what happens. Sent from my SM-G530T using the BariatricPal App