Another UHC question. Help!!

[bluebinder 0]

So, I got the list of requirements from UHC today. My plan requires a BMI of 40 or over, or a BMI of 35 to 40 with two co-morbidity conditions. My BMI is 40.8. Another requirement is one year of weight managment effort medically documented by my physician. Monthly visits were not required.

I have never been in a medical weight loss program, but my doctor is well aware of my weight loss efforts. I have been seeing the same doctor since 2002, and we have discussed my weight at length. She referred me to Weight Watchers, as well as discussing diet and exercise. I have a gym membership and I am also registered with an online weight managment program (Spark people). I am meeting with my doctor tomorrow to see if she will put all this in a letter for me. Do you think this will be enough to satisfy UHC??

[Crabadams72 20]

So, I got the list of requirements from UHC today. My plan requires a BMI of 40 or over, or a BMI of 35 to 40 with two co-morbidity conditions. My BMI is 40.8. Another requirement is one year of weight managment effort medically documented by my physician. Monthly visits were not required.

I have never been in a medical weight loss program, but my doctor is well aware of my weight loss efforts. I have been seeing the same doctor since 2002, and we have discussed my weight at length. She referred me to Weight Watchers, as well as discussing diet and exercise. I have a gym membership and I am also registered with an online weight managment program (Spark people). I am meeting with my doctor tomorrow to see if she will put all this in a letter for me. Do you think this will be enough to satisfy UHC??

Call UHC directly and ask to speak to the bariatrics coordinator. I have UHC and they require a 6 month supervised "failed" attempt of weight loss within the past 12 months. The doctors visits must be coded correctly as "diet counseling", the doctor must weigh you and note your diet plan/exercise plan over those 6 months. I am working towards this as we speak and expect to get sleeved around May or June. Good luck!

[FuriosMommy 3]

I would have your doctor write a very detailed note regarding your weight loss attempts and any recorded weights that you may have from SP or WW. I was in a similar situation. After submitting everything my nurse coordinator kept telling me she didn't receive anything, after 5 more attempts, she said she still didn't receive anything. I requested a change of a nurse and the next day I was approved. If you have any trouble with your assigned nurse just let them know and ask for a re-assignment. UHC can offer really good coverage if you can squeeze it out of them. Good luck, I hope you don't have the run around I had, but here I am 2 weeks out from being sleeved so it will all work out. Also, it varies so much depending on employers specifications so definitely check in with the bariatric coordinator and find out more details.

[bluebinder 0]

I would have your doctor write a very detailed note regarding your weight loss attempts and any recorded weights that you may have from SP or WW. I was in a similar situation. After submitting everything my nurse coordinator kept telling me she didn't receive anything, after 5 more attempts, she said she still didn't receive anything. I requested a change of a nurse and the next day I was approved. If you have any trouble with your assigned nurse just let them know and ask for a re-assignment. UHC can offer really good coverage if you can squeeze it out of them. Good luck, I hope you don't have the run around I had, but here I am 2 weeks out from being sleeved so it will all work out. Also, it varies so much depending on employers specifications so definitely check in with the bariatric coordinator and find out more details.

Thank you so much! I have my information seminar at the hospital on Saturday, 1/22. Do you suggest that I call UHC and ask to speak to a nurse coordinator before that? I am just trying to stay ahead of the game

[FuriosMommy 3]

Thank you so much! I have my information seminar at the hospital on Saturday, 1/22. Do you suggest that I call UHC and ask to speak to a nurse coordinator before that? I am just trying to stay ahead of the game

It wouldn't hurt to give them a call to get some clarifications on all of your requirements. In my experience the phone reps weren't any help at all. They didn't know any of my specific benefits or requirements, they could only speculate. But, they also didn't offer to forward me to the correct people that could help me, which was a bummer. Just keep pushing. With UHC the squeeky wheel gets the grease. Good luck!