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I could really start to hate UNITED HEALTHCARE



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I have been battling with UNITED HEALTHCARE for about two weeks trying to findout exactly what my benefits will cover. I have been informed by my "bariactic coordinator" that for the VSG is not currently covered. UHC will only cover the lap band or the surgery that rearranges all the plumbing. So my situation is do I get the band until I can afford to pay for the VSG (Dr. Wathkins) out of pocket???? It's pricey but I could have all the money in about a year, ANY OPINIONS, ANYBODY!!!!!!!!!!!

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If your surgeon has decided to do the VSG, they should talk with your insurance company and explain why they are choosing that route.

That's what happened with me, my insurance covered the Bypass but not a sleeve.

My surgeon said that because I'm a big person the sleeve would work better for me and would be a quicker less risky surgery.

They initially denied my sleeve, I signed papers for my surgeon to appeal on my behalf and it was done...

Talk with your surgeon.

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I have Medica which is adminsitrated by United Healthcare, In fact the bariatric policy is United Healthcare's policy and Gastric sleeve is covered by UHC. No longer considered investigational. Ask to see a copy of their current policy, Do not take their word for it! I was originally told that the Sleeve was investigational and not covered. I pointed out the policy has been revised and offered to send them a copy of the one I found on their website. They were looking at an out of date policy!

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Have your surgeon put in for approval, if you get denied appeal it, and dont give up! I Had to keep pushing for damn close to a year, but I finally got approved just yesterday.

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That is crazy. I had never heard of the sleeve until I called UHC and they said for our particular policy the sleeve, the band and the RNY was covered. We were told that it just started being covered this year by UHC. I would keep trying and ask for written documentation!

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I have UHC for Railroad employees. And they do in fact cover th sleeve. I was approved in 3 days, just sleeved on 12/21. They have been nothing but awesome with me. Have you asked for a case manager? If not, I would. Also, it doesnt hurt nothing for the surgeon to submit it anyway and later appeal. Best of luck to ya!

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I have United Healthcare Choice and they cover bariatric surgery, was approved in less than a week and all that was required was 5 years worth of medical records and a psych evaluation.

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