Anyone With Uhc

[jen_1381 446]

Everlag - you should have a WLS coordinator who will get all of your benefits in writing before you begin the process.

In my case, she got the policy details at the beginning of March. When they applied mid-May for auth, UHC denied it because I didn't have two comorbidities (even though the three different people we spoke to said 1 comorbidity was fine, as did the paperwork she was able to reference). I technically did have two, high cholesterol and high blood pressure, but when the surgeon submitted paperwork he didn't put "Uncontrolled Hypertension", just simply "Hypertension". The surgeon had to do a conference call with the approval board at UHC and they approved it - - the DAY before surgery!

I totally believe that the patient is responsible for knowing their benefits, but the technical stuff I left to my coordinator. They actually told us in our WLS Seminar that most times if you call and talk to two different people you will get two different answers.

[Scooterbug 13]

Hi, I have a question. I just called uhc twice, spoke with benefits and eligibility dept and both reps stated that only requirement it BMI over 35 with comoridity or BMI over 40. As much as I would love to believe that, I'm struggling to. Any suggestions on how else to verify requirements? TIA

That's the same information my wife and I got on 4 or 5 different occasions when we called. When our surgeon's office called to get the requirements they said it was BMI over 35, 5 years weight history, 6 month PSD (Physician Supervised Diet), and a few other things. Even our booklet says the only requirement is 35 BMI +. Guess the doctor's office has certain people they talk to that give them the CORRECT info

[everlag 18]

Thank you for the responses ...Looks like I've officially started my process. Informational session was 8/8. Received a call 8/10 from the wls office stated that they received benefit info and its covered ( which i knew) the coordinator received the same benefit info i received. So I am scheduled for my consult on 8/31. Im so nervous, anxious, and excited all at the same time. So a coworker keeps reassuring me that she did not have any additional requirements from the ins co. Only three required tests by the surgeon. My only concern now it that i have been working out since April and have lost 17lbs which puts me at a bmi of 34... Of course i need a bmi of 35 with hypertension. I was thinking of putting my workout on pause until sept 1st. But this thought really scares me. So today while driving and my arms were aching due to arms workout yesterday, i thought maybe i should just work to build more muscle instead but we are talking a 5 lb difference. Wonder if that is even possible. I scheduled an appt for april 2012 before starting my workout and did not go, if i had i would not be in this situation. Anyhow, im glad to finally have the ball rolling on this.

[a1990 55]

I have Uhc and I did not.have to do anything but have 5 year history of my weight

[texasgal77 19]

I too have UHC and live in Texas. I have to go through the 6 month process as well. The sucky part about having to wait the 6 months is that I have already met my deductible this year but since I have to wait 6 months, I will have to pay my deductible again in February. My BMI is 38 but I don't have any comorbid diseases (yet).