Anyone with United Healthcare?

[bmarchi 0]

I have UHC and on the policy it says no weight loss surgery. I have called and asked but have told me no. My doctor said they will write a letter but that I need to do the footwork and then they will write it. I am diabetic and have high blood pressure plus I am well over the required BMI needed to qualify. Do any of these doctors offices help with approvals from the insurance companies? I would be open to any suggestions. I am in the Houston/Galveston area.

[MsSouthernBelle 0]

I didnt have diabetes or anything. Just overweight. I got approved in 3 days from UHC. Its a PPO. I was required by my doctor to see around 6 doctors. A nutritionist, gastroenterologist, psychiatrist, pulmonary, cardiologist, and someone else, plus they took bloods, just went through a lot of red tape, which took a week because I was determined and could work around a schedule. UHC is cool. They also approved a breast reduction in 5 days. That is scheduled for August because they said in order to avoid another lift, to wait until I lost some weight.

[Alexandra 55]

Bmarchi, does your specific plan have a written exclusion for weight loss surgery? If that's the case, you should find out if it was put there by your employer, and if appealing to your company can help. Large companies can write their own policies, and the good news about that is that they can call their own exceptions. United Healthcare nationally is pretty band-friendly, so if it's written out of your policy it's probably someone else making that determination. Finding out who will be your first step toward making an appeal for an exception.

[chichigirl 1]

That's unusual for UHC, they are well known for approving bariatric surgeries. It's entirely possible however, that your employer requested this omission of coverage. It's not unusual of employers to do this to reduce their premiums. Check with your HR department or whoever it is that handles the insurance for your company.

I am currently on Medicare myself, due to disability, and I purposefully chose UHC as my HMO because of their positive attitude towards all of the bariatric surgeries.

Good luck, hope you can get things turned around in your favor. I wish you all the best. You may also want to check out the Insurance boards on here and see what other people have encountered with UHC and other insurance companies.

Cindy

[bmarchi 0]

Gosh that was my first actual posting on a website, and y'all were awesome! Thank you so much for all of your informatioin. I will call our HR department tomorrow; I'll let you know what happens. Thanks!

[graceysnema 0]

i had united health care i used spivak in houston my policy went forward and approved in 5 days. and it only cost me a copay of 30 dollars. i am not for sure if we have same policy or not why dont you call dr. spival and get his office to help.

[YellowRose 0]

My former employer was self insured, but processed thru UHC. The employer did not carry the weight loss surgery. Other wise I would have had the surgery a year ago. I am praying that my new employer carries the coeverage.

[BCLYNN 0]

I have UHC PPO and I was approvel in two weeks Dr.Ferrari office was GREAT he is at Memorial hermann on I-10.

hope you get it soon. I was banded 3.28 and have lost 9lbs and loving it.

take care

lynn:)

[NurseTeresa 0]

I like you have UHC and weightloss is an Exclusion! I have called and called until I was blue in the face. The exclusion is because of the underwriters of the policy per my employers specifications. I did go to the people at HR and has several other fellow employees regarding this and there has been no change. All they will say is NO not at this point but we may include it in the insurance for next year. Tell me what sense it makes to be a hospital that does lapbanding and RNY bypass but the employees cant even get the flippin surgery!!! That is about the dumbest crap I have ever heard. I would love to be doing whatever the precerts they will require if it is included in next years policy but who knows what they will want you to do. Have a drs appt Fri will ask him to start documentation on a supervised weightloss program so that way I will have that for 8 months if they only want 6mos I will be covered. Best of luck with approaching your HR department to see if they will approve it via an appeal from you. Keep me posted please!

[shauntil6266 0]

Yea I Am A Uhc As Well I Got Approve In About 4 Days.

[barbara465 2]

I am with UHC PPO. I called and they said I was covered. However, I noticed that the consultation fee for Dr.Spiegel is being held for more information. It has now been 3 weeks and no letter or payment processing. I think they are just dragging their feet because my policy does cover it. I think for me its time to be more aggressive.

[barbara465 2]

I am now approved. I had to shake up UNC and Dr.'s office. I was approved, but insurance was waiting for office notes from Doctor. Made them talk and viola, got approved.

I am so excited.

[Pam Tx 0]

I have UHC PPO plan. It covered 80%. I had an approval letter in my hand 8 days after my appointment with my surgeon. No other doctors were involved. I was amazed.

Coverage depends on your specific plan is. Call them and ask specifically, "is bariatric surgery covered on MY plan?" I did that and they said yes, for my particular policy.

I automatically thought it would NOT be covered when I reviewed the UHC web site. So glad I called them.

Good luck!

Pam

banded 3/24 by Dr. Speigel

down 15 pounds....

[Jantique 0]

I have UHC PPO as well. Previously I had Cigna. Both plans are through my employer. My internists had been documenting the need for surgery for about five years. I wrote, called, campaigned with Cigna for 2 years to get lap band, but they would only approve GBP, which I didn't want. My employer's health care advocate told me last year that it was my employer that determined what coverage is permitted under the plans. Then I heard from another employee that UHC would pay for LB. So during the annual enrollment period last November, I switched from Cigna to UHC. Then I called everyone I could reach at UHC to make sure it is covered. Then I called my employer's health care advocate, who conferenced in UHC and UHC again said it was covered. Oddly, the health care advocate didn't raise the issue of what my employer would approve. Then I had the consultation with the surgeon and within 2 weeks he had the lapband approval from UHC. Just like Pam, no other doctors were involved. I had to pay $2,000 of the $10,000 hospital fee, but the surgeon said he would accept whatever UHC paid him. I haven't seen any summary paperwork from UHC. I'm hoping that I receive something that says the insurance has paid the balance of the bills! I wish I had switched a year earlier!

[squiggle 1]

i have united ppo and it was denied due to being listed specficially as an exclusion on my employer's policy. if that's the case with your policy, no amount of appealing united will make any difference at all, unfortunately.

amanda