united health care approval?

[AlyAnne 2]

im currently trying to get approved by uhc and i wanted to see if there was anybody here that was approved or denied by them. i want to hear your story to get a feel for my chances. thx so much! please respond! i need some help.

[DrmBig4Evr 152]

im currently trying to get approved by uhc and i wanted to see if there was anybody here that was approved or denied by them. i want to hear your story to get a feel for my chances. thx so much! please respond! i need some help.

As with anyone, each plan is different for each employer. If your insurance does cover bariatric surgery and your bmi is over 40, depending on your requirements you should get approval easily. According to my surgeon's office as well as many others on here, UHC is the best to work with for lap band, they understand the cost savings. I should have a denial or approval this week, it is taking longer for me because my bmi is right at 35. I will respond to this once I hear back. A tip would be to call UHC and see if bariatric surgery is a covered benefit under your plan, then find out what documentation you need to submit for approval. I needed 5 years of morbid obesity documentation (other peoples plans do not require this), I also needed to document any significant health issues. However, like I said, if it is covered, most insurance plans automatically cover it with a bmi of 40 or over, just make a call. Once you submit the documentation it takes a few days to show up in their system, they usually have 15 days to approve or deny it.

[DrmBig4Evr 152]

Also, wanted to add that they do require a psych eval and sometimes a nutritional evaluation and physical before submitting.

[AlyAnne 2]

Also, wanted to add that they do require a psych eval and sometimes a nutritional evaluation and physical before submitting.

i think we have the choice plan. they said i needed history of over 40 bmi for 5 years or 35 with at least 2 co-morbidities. also needed previous history of weight loss attemps under dr. supervision. i will need evaluations as well but that will go through my dr office as soon as we get the go ahead. basically im scared they will say i dont have enough documentation. i did curves 3 days a week for 6 months on 1600 cals but im scared i didnt get it documented enough. and on my 5 year history i've been over 40 every year except the first. i was at 33.6 bmi, but i was also only 15. i dont know how they will view that. idk. before i started this i thought i would be covered for sure but im not too sure now. thx for responding. i wish you the best of luck!

[DrmBig4Evr 152]

Yes I have the choice plan, but from what I understand mine only required over 40 bmi, the 5 year history was for under 40...you may want to clarify that. Also, I have documentation for only 09 and 10 and I had to write a letter, I did have 12 months of supervised diet and also submitted all the weight loss plans I was on like Atkins, Weight Watchers, etc. In my opinion you should get approved...let me know what happens! Good luck!

[AlyAnne 2]

thx! i hope so! my drs office sent in a letter i think. idk. they said they would handle it but im kinda wishing i asked more before they sent it. i havent had the evals yet and hopefully insurance knows i will get that through my dr. idk. i will call them tomorrow. im worring a ton.

[LauraRN 2]

I also have UHC buy up plan.....first the Dr must be at a center for excellence or they will not cover the lap band......The hardest part for me was the 6 months working with a nutritionist .....6months is like forever.....I went to DR Thomas Brown in Denver Co. thru pres/St Lukes......they found out all the insurance info for me and if I would be excepted.....they did some nutrition evals, psych evals.....but I have to produce 2 years of my weights, not a problem, letter from my primary care, nutrition classes one a month for 6 months. BMI over 40 or 35 and over with comorbitities , All in all it was very pleasant there, the staff is wonderful........I thought the 6 months would kill me but it is half thru...I used the time to work on the hardest of my addictions, candy ,diet sodas ,sugar......I'm excited beyond words, Thanks for this forum., Where I can see the results If you use this tool properly......the ups and downs are important to know so I know I'm not alone and the bad days will pass........hugs Laura

[JinTx 19]

im currently trying to get approved by uhc and i wanted to see if there was anybody here that was approved or denied by them. i want to hear your story to get a feel for my chances. thx so much! please respond! i need some help.

All UHC plans are different. I have UHC and submitted psych eval, last 6 months of WW records, and 2 doctor notes that occurred w/in that 6 mos of WW records. My BMI was 40. My request was submitted on a Friday and by Tuesday morning it was approved.

Best thing to do is call UHC or look at your written benefits summary and see what the requirements are.

J

[LauraRN 2]

Thanks. I really think I have done everything they asked of me, you give my hope it may be easy for me too....... hugs Laura

[AlyAnne 2]

thx guys for the input! me and my mom are trying to get to the bottom of it right now. yesterday i called the drs office and they said my insurance required 3 months on their diet plan but we have been calling today and everything points toward approval. we're trying to figure out whats going on.

[DrmBig4Evr 152]

thx guys for the input! me and my mom are trying to get to the bottom of it right now. yesterday i called the drs office and they said my insurance required 3 months on their diet plan but we have been calling today and everything points toward approval. we're trying to figure out whats going on.

Just an FYI, I was denied, my weight 4 years ago fell below 35, I am in the appeals process. Good luck in your endeavor! I will still be around, planning on self pay and appeal, if I win, I will submit the bill.

[AlyAnne 2]

Just an FYI, I was denied, my weight 4 years ago fell below 35, I am in the appeals process. Good luck in your endeavor! I will still be around, planning on self pay and appeal, if I win, I will submit the bill.

aww im sry! good luck with appeals. i wish you all the luck. i had my eval the other day and i need to finish 3 other counseling sessions and hopefully we will be approved. (me and my mom)

[SumthinsGottaGive 35]

I have UHC through my job. I called them after I decided this is the right option for me. I have and always do get the best plan, so I pay out more but they told me they would cover 100% after my $200.00 deductible and all I need to qualify is a diagnosis of morbid obesity from my doctor. I was so shocked that that's all it took..she told me it's different for each plan but because I have the best that's all they need from me. I don't know if that will change or remain the same once I actually start the process..but I'm seriously hoping it remains the same.

All the best!

[AlyAnne 2]

I have UHC through my job. I called them after I decided this is the right option for me. I have and always do get the best plan, so I pay out more but they told me they would cover 100% after my $200.00 deductible and all I need to qualify is a diagnosis of morbid obesity from my doctor. I was so shocked that that's all it took..she told me it's different for each plan but because I have the best that's all they need from me. I don't know if that will change or remain the same once I actually start the process..but I'm seriously hoping it remains the same.

All the best!

wow, thats awesome. my mom has a pretty good plan too. not as good as yours though. the approval so far is going better than i expected for me though. and i was reading on our benefits that they dont charge any one person more than $1000 on approved surgery. its a lot but also less then some people have to pay.

[SumthinsGottaGive 35]

wow, thats awesome. my mom has a pretty good plan too. not as good as yours though. the approval so far is going better than i expected for me though. and i was reading on our benefits that they dont charge any one person more than $1000 on approved surgery. its a lot but also less then some people have to pay.

Yes..that's very true! I've seen people say they had to pay about 3k.. I am very grateful for my insurance! I have my seminar next week.. I'm very fresh to this but, very well informed.. I can't wait to get started on the process! Hopefully, once I meet with the surgeon things will flow pretty quickly from there.

All the best on your journey!