Uhc Approved My Surgery

[Artsy 48]

May 7......Houston, TX.

Thanks to all of you for your best wishes and support for this Chapter in my Journey.

Wishing others the best in dealing with insurance!

Ii'm looking forward to the next Chapter and the next and the next. I'll post my progress on this board.

Xoxo

[PEvette 297]

congrats congrats!!

[vivienvixon 1]

Congrats!

[tinalharris 0]

did you have a difficult time getting them to approve it? I have the same ins co and I've heard they are horrible???

[vivienvixon 1]

I have UHC as well. I am so scared they wont approve me!

[Giselle3264 175]

My information goes to UHC tomorrow. I've tracking this forum and see many people approved in 2-4 days. So I plan to call them Tuesday and make sure they have everything and that it's moving along. I'll keep you posted.

[tinalharris 0]

I had my dr appt today but mines a different circumstances. 15 yrs ago I had vertical banded gastroplasty and it's totally destroyed. Ins will pay to have the surgery repaired but I would have to meet the requirements for a new surgery. The new requirements are BMI over 40, over 21 yrs old and 5 yr history of morbid obesity. I fit the first 2 requirements and wondering about what they base the 5 yr history on. Hoping and praying for an approval!

[Giselle3264 175]

My only concern is the BMI over 40 for 5 years. I have a gap in my history where I was under 40 BMI but then rose again. As a result, my surgery coordinator is using my comorbidities of hypertension and sleep apnea. UHC doesn't state it makes allowances for comorbidities but that certainly should matter. In your case, they certainly shouldn't want you to wait until your BMI is over 40 all over again for 5 more years!! I'll be praying for you too!

G.

[Artsy 48]

I have UHC too. Once my paperwork was submitted, they came back wanting a sleep study and a psychologist report. Then once my doctor's office received that information, it was 4 days later I got the approval.

[Artsy 48]

I have UHC too. Once my paperwork was submitted, they came back wanting a sleep study and a psychologist report. Then once my doctor's office received that information, it was 4 days later I got the approval.

[Giselle3264 175]

@Artsy Did approval come in the mail or phone call? I'm on pins and needles. Maybe I'll sleep next to the mailbox with my cell phone. ARGH! :ph34r:

[Artsy 48]

My doctor's office called me right away upon approval & I received a letter in the mail. It probably wouldn't hurt to call UHC.

[Gastricsleeve4me 186]

I had my dr appt today but mines a different circumstances. 15 yrs ago I had vertical banded gastroplasty and it's totally destroyed. Ins will pay to have the surgery repaired but I would have to meet the requirements for a new surgery. The new requirements are BMI over 40, over 21 yrs old and 5 yr history of morbid obesity. I fit the first 2 requirements and wondering about what they base the 5 yr history on. Hoping and praying for an approval!

To all who have UHC and are stuck on the 5-yr requirement...MAKE SURE YOUR DOCTOR/SURGEON IS WORKING OFF OF CURRENT INFORMATION! I saw one surgeon here in NJ who told me of the 5-yr requirement, which I don't have, so I assumed insurance was off the table and started researching Mexico. After weeks/months of planning for Mexico I popped into another NJ surgeon who seemed to be a little more organized...and told me that UHC dropped their 5-yr requirement recently. I was blown away that now I could be covered. After much agony, I ultimately decided to go to Mexico anyway (in 1.5 weeks!) to circumvent the 6 mos of nutrition appts and the chance that it might not be covered in the end...mostly because I'd done all this planning and was so excited to move forward.

If you're really curious, I blogged about it in the following two blog posts:

http://gastricsleeve4me.blogspot.com/2012/05/insurance.html

http://gastricsleeve4me.blogspot.com/2012/05/mexico-it-is.html

[vivienvixon 1]

Do u think the 5 year history was dropped across the board? Or only in your case. Meaning maybe your coverage from your work is different then mine, even though we both have UHC.

[Giselle3264 175]

You are correct, there are different requirements in UHC based on the plan and the employer. I checked our specific plan and called them right after the consult. The 5 year history of BMI of 40+ and the use of a Center of Excellence is the only requirment for me to get 100% coverage. The physician has to be in network. If I don't use the COE, I only have 80% coverage for the facility (if it's in network.) But check your plan for your employer to be sure.

G.