Jump to content
×
Are you looking for the BariatricPal Store? Go now!

what does this mean exactly?



Recommended Posts

I have uhc and they cover the surgery foe morbid obesity... then when I go to the glossary for their def of that it says bmi of 40 etc... then it says 3 years of medically supervised diets with 2 doc.. WTF who does that? Anyone ever heard of this? Can u get around it or appeal?? Thanks

Share this post


Link to post
Share on other sites

every insurance plan is different... even with the same provider. I have UHC and all I needed was a BMI of 40 or a BMI of 35 with co-morbidities. My plan also only covered 80% of expences. Call and talk to someone and find out exactly what your plan requires! Best of luck

Share this post


Link to post
Share on other sites

The insurance requirements vary so much. It really is best to call your provider and ask what requirements you need to meet in order to have WLS covered. It's not rare that an insurance company wants a patient to do a diet before surgery.

You can appeal if you get disapproved but I don't believe you can appeal the criteria.

Share this post


Link to post
Share on other sites

It may mean 3 years of medical weigh in's. Like when I went to my obgyn each year, they weighed me and it counted for my insurance as a medically supervised weigh in. I still had to do 6 month supervised diet though.

Edited by PuppyBandit
Typo

Share this post


Link to post
Share on other sites

ok so the doc called and definitely confirmed what i mentioned earlier about the 3 years of supervised diets... really who gets their doc to supervise ww or nutrisystem or any other of the million diets they have done. Doc said we can get medical records to at least have weight records and see if at anytime i was taking any diet pills etc... and maybe we can piece something together. Anyone ever do anything similiar??? sooo frustrated. so on another note if i end up having to pay cash any low cost recommendations here in Texas or Mexico?? Thanks for any advice.:biggrin:

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • buildabetteranna

      I FINALLY HAVE MY DATE!!!!

      · 0 replies
      1. This update has no replies.
    • Alisa_S

      Gearing up for my consult 01/14! Starting to get a little nervous.
      · 0 replies
      1. This update has no replies.
    • Goyafigs

      I had VSG 11.20.24 with Miguel Burch, MD Cedars-Sinai and I am 1 month post-op. 
      · 0 replies
      1. This update has no replies.
    • DaisyChainOz

      🥳 Jan 1 2025 - Day 1 of Pre Op, surgery on the 16th! 😬😅
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      Just been waiting until time for my consult with my bariatric surgeon. It's scheduled for Jan 9th. Turns out I won't actually be seeing him. Apparently it'll be with his P.A.             Not sure what to expect. I thought this is where the surgeon would discuss the best surgery option for me. For years I had my heart set on the sleeve, but I've read so many people have issues with reflux - even if they've never had it before - that they've had to be revised to the bypass. I already deal with GERD & take 40 mg of Omeprazole daily, so I started studying about bypass and honestly, it seems like it might be the better choice for me. How can we discuss surgery options if the surgeon is not there?
      What happened at your first consult? Trying to get an idea of what to expect, or maybe I should say, what NOT to expect.
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×