ginafur 0 Posted December 16, 2010 Back in November, I called our insurance...United Healthcare. (We have the Choice Plus coverage.) I was told that my UHC plan would cover 100% of my surgery. I even asked if there were any prerequisites. The only one was morbid obesity, which I fit! My first doctors appointment was December 7 with a Dr in the UHC Network. I got there, signed in. The insurance lady called me back, told me she spoke to someone with UHC and that my insurance didn't cover any weight loss surgery. I went to the parking garage, cried my eyes out, and then called UHC. Spoke to someone that said yes, indeed, it did cover the surgery. I was so excited that I took my cell phone back into the office. The insurance lady talked to the UHC rep on my cell phone. Anyway, the dr's office asked for a fax of the coverage. We waited...and waited...and waited. I called back, to which this whole cycle restarted. Yes it is covered. No, it's not. I never got to even see the doctor that day. Devastated, I called, very angrily, and wanted answers. I spoke to someone that told me to have the dr.s office fax a "prerequisite" letter to UHC, stating WHY I needed the surgery. She said my plan did cover the surgery and any surgery for weight loss, under the morbid obesity section. The reason the customer care reps kept saying no was because it always said "Need additional informatiuon." Has anyone else has this kind of luck with United Healthcare? That day, the doctors office, to which I am not even a patient, faxed a letter stating I needed the lap band, due to morbid obesity. We are still waiting to see whether it's going to be accepted or denied. I will tell you that the surgery code # was put into my plan and it was covered. This is all just so devastating to me! The insurance lady @ the dr.s office told me a rep called her from UHC today, but really didn't know whether or not the surgery was covered. Said she would have to refer it over to the UHC nurse case worker. SERIOUSLY? How hard can it be to know whether or not this surgery is covered? I am really down at this point. The lap band feels years away~ :(Just wondering if anyone else has had this kind of luck, with a good outcome from UHC? Share this post Link to post Share on other sites
PhilC 5 Posted December 16, 2010 I have UHC and was approved on that reason 1 ginafur reacted to this Share this post Link to post Share on other sites
ginafur 0 Posted December 16, 2010 I have UHC and was approved on that reason What reason? Because your doctor sent a prerequisite letter?At least it was good news for one of us! The insurance lady said UHC is awful with the approval~ she said she's even had people have the lapband completed, then UHC deny coverage~ UGH! Share this post Link to post Share on other sites
PhilC 5 Posted December 16, 2010 Yes, they sent the pre letter, and I was "morbidly obese". Took about 3 weeks for approval. Share this post Link to post Share on other sites
schis814 0 Posted December 16, 2010 Back in November, I called our insurance...United Healthcare. (We have the Choice Plus coverage.) I was told that my UHC plan would cover 100% of my surgery. I even asked if there were any prerequisites. The only one was morbid obesity, which I fit! My first doctors appointment was December 7 with a Dr in the UHC Network. I got there, signed in. The insurance lady called me back, told me she spoke to someone with UHC and that my insurance didn't cover any weight loss surgery. I went to the parking garage, cried my eyes out, and then called UHC. Spoke to someone that said yes, indeed, it did cover the surgery. I was so excited that I took my cell phone back into the office. The insurance lady talked to the UHC rep on my cell phone. Anyway, the dr's office asked for a fax of the coverage. We waited...and waited...and waited. I called back, to which this whole cycle restarted. Yes it is covered. No, it's not. I never got to even see the doctor that day. Devastated, I called, very angrily, and wanted answers. I spoke to someone that told me to have the dr.s office fax a "prerequisite" letter to UHC, stating WHY I needed the surgery. She said my plan did cover the surgery and any surgery for weight loss, under the morbid obesity section. The reason the customer care reps kept saying no was because it always said "Need additional informatiuon." Has anyone else has this kind of luck with United Healthcare? That day, the doctors office, to which I am not even a patient, faxed a letter stating I needed the lap band, due to morbid obesity. We are still waiting to see whether it's going to be accepted or denied. I will tell you that the surgery code # was put into my plan and it was covered. This is all just so devastating to me! The insurance lady @ the dr.s office told me a rep called her from UHC today, but really didn't know whether or not the surgery was covered. Said she would have to refer it over to the UHC nurse case worker. SERIOUSLY? How hard can it be to know whether or not this surgery is covered? I am really down at this point. The lap band feels years away~ :(Just wondering if anyone else has had this kind of luck, with a good outcome from UHC? Share this post Link to post Share on other sites
schis814 0 Posted December 16, 2010 I Have UHC and was approved, first request. I had to see a whole bunch of doctors before my surgeon sent in for authorization. My surgeons office knew before hand, from experience, if it was going to be a problem. I had the insurance language that WLS was excluded unless morbid obese. Hope this helps. Back in November, I called our insurance...United Healthcare. (We have the Choice Plus coverage.) I was told that my UHC plan would cover 100% of my surgery. I even asked if there were any prerequisites. The only one was morbid obesity, which I fit! My first doctors appointment was December 7 with a Dr in the UHC Network. I got there, signed in. The insurance lady called me back, told me she spoke to someone with UHC and that my insurance didn't cover any weight loss surgery. I went to the parking garage, cried my eyes out, and then called UHC. Spoke to someone that said yes, indeed, it did cover the surgery. I was so excited that I took my cell phone back into the office. The insurance lady talked to the UHC rep on my cell phone. Anyway, the dr's office asked for a fax of the coverage. We waited...and waited...and waited. I called back, to which this whole cycle restarted. Yes it is covered. No, it's not. I never got to even see the doctor that day. Devastated, I called, very angrily, and wanted answers. I spoke to someone that told me to have the dr.s office fax a "prerequisite" letter to UHC, stating WHY I needed the surgery. She said my plan did cover the surgery and any surgery for weight loss, under the morbid obesity section. The reason the customer care reps kept saying no was because it always said "Need additional informatiuon." Has anyone else has this kind of luck with United Healthcare? That day, the doctors office, to which I am not even a patient, faxed a letter stating I needed the lap band, due to morbid obesity. We are still waiting to see whether it's going to be accepted or denied. I will tell you that the surgery code # was put into my plan and it was covered. This is all just so devastating to me! The insurance lady @ the dr.s office told me a rep called her from UHC today, but really didn't know whether or not the surgery was covered. Said she would have to refer it over to the UHC nurse case worker. SERIOUSLY? How hard can it be to know whether or not this surgery is covered? I am really down at this point. The lap band feels years away~ :(Just wondering if anyone else has had this kind of luck, with a good outcome from UHC? Share this post Link to post Share on other sites
ginafur 0 Posted December 16, 2010 YAY~ The doctor's office called this morning and the lady from UHC, she was a claims specialist, called and said I was approved~ No prerequisites, per my policy. I was happy, just hate I don't have anything in writing. My appointment has now been scheduled for Jan.10! Share this post Link to post Share on other sites
bwhitty 1 Posted December 16, 2010 I have UHC, I had 3 items from them I had to meet, BMI, Obese 5yrs+ & Diabetes. My surgeon had like 7 things I had to have done . I was approved in 5 days. Good luck! Share this post Link to post Share on other sites
Mariasha 3 Posted December 16, 2010 YAY~ The doctor's office called this morning and the lady from UHC, she was a claims specialist, called and said I was approved~ No prerequisites, per my policy. I was happy, just hate I don't have anything in writing. My appointment has now been scheduled for Jan.10! Good for you!! Happy to hear it worked out. Share this post Link to post Share on other sites
Mercedes52 0 Posted December 17, 2010 I have UHC and was approved witihn 10 days after being diagnosed with sleep apnea, high blood pressure and a BMI of 38. Dec 22nd is my banding date! Geting a little nervous. Share this post Link to post Share on other sites
ginafur 0 Posted December 17, 2010 Thanks everyone! Share this post Link to post Share on other sites