ttammara 11 Posted November 25, 2012 I am have United Healthcare. I work for UHS. They told me on the phone I am covered for Bariatric Surgery and only gave the requirements of BMI 35 to 39 with two co-morbitities or above 40. I am worried I read all the hell the insurance companies have been putting people. Share this post Link to post Share on other sites
bigtigger1010 45 Posted November 25, 2012 I have uhc n was covered with a bmi over 40, would've been with 35-39 & 2 co-morbidities too... but from what ive heard, its not the company that decides ur coverage & what requirements u must meet (ie: bmi, diet attempts, etc), but actually ur employer decides what specs they want written into ur policy... i called 3 times n spoke to diff reps just to make sure i got the same answer from each... lol... **good luck!!!** Share this post Link to post Share on other sites
ttammara 11 Posted November 25, 2012 Thanks I called 4 times and they never said anything about the 6 month diets. I am keeping my fingers crossed. My BMI is 40.6. Share this post Link to post Share on other sites
lizy0916 18 Posted November 25, 2012 Thanks I called 4 times and they never said anything about the 6 month diets. I am keeping my fingers crossed. My BMI is 40.6. I have united health I'm in my 6 month supervise diet. In december us going to be my 3 rd month. Share this post Link to post Share on other sites
ProudGrammy 8,322 Posted November 25, 2012 I am have United Healthcare told me on the phone I am covered for Bariatric Surgery and only gave the requirements of BMI 35 to 39 with two co-morbitities or above 40. I am worried I read all the hell the insurance companies have been putting people. ttammara hi there i would ask United Health Care for some type of "written authorization" saying that you have been "blessed" I was approved by United Health Care i also would check to find out the pre-requisites for being approved - i know they told you about the co-morbities and BMI - sounds good I have heard stories here where people say that they were approved on the phone, then prior to WLS, they found out they weren't approved just playing devil's advocate - not meaning to scare you sounds great that insurance said "all is well" - i would just feel better with written confirmation, but thats just me good luck Share this post Link to post Share on other sites
lakobe00 63 Posted November 26, 2012 I have UHC. I had to have the six months weight management. I have been approved, but my plan only pays 50%.....My surgery is scheduled for Dec.9. Share this post Link to post Share on other sites
Heyher 581 Posted November 26, 2012 I have UCH and it has been so stressful. My requirements are Current BMI 40+ BMI of 40+ for 5+ years Over the age of 21. UHC has used the 40+ for 5+ years to deny me over and over. Finally made it through all internal appeals and went to external appeal. I hope I hear this week the final answer. My fingers have been crossed for 5 months now. I just hope the external review does see this as medically necessary... 2 Lorelei and DreamsOfSkinny reacted to this Share this post Link to post Share on other sites
TaraInDC 55 Posted November 26, 2012 I have United and I was able to get approved on my first try - I did not do the 6 month diet (it doesn't say in their requirements anywhere that it's required) and I have no co-morbities. Good Luck! Share this post Link to post Share on other sites
lizy0916 18 Posted November 26, 2012 HelloHayher. Good luck, im in suspence because I'm 40.5 on BMI & I'm doing the 6 month diet. That insurance request. But I know my insurance cover bypass not gastro sleeve but I don't want the bypass. Will see how it goes Im keeping my fingers cross lol. Good luck Share this post Link to post Share on other sites
lizy0916 18 Posted November 26, 2012 HelloHayher. Good luck' date=' im in suspence because I'm 40.5 on BMI & I'm doing the 6 month diet. That insurance request. But I know my insurance cover bypass not gastro sleeve but I don't want the bypass. Will see how it goes Im keeping my fingers cross lol. Good luck[/quote'] Sorry forgot to let you guys I had the lap band fir 7 yrs. got it removed 2 yrs ago. Hopefully that will count. Share this post Link to post Share on other sites
takroom 192 Posted November 26, 2012 I have UHC & was DENIED!!!! I tried 3 times to get approval & was unsuccessful so I had to pay out of pocket!!! Share this post Link to post Share on other sites
DreamsOfSkinny 53 Posted November 28, 2012 I have UCH and it has been so stressful. My requirements are Current BMI 40+ BMI of 40+ for 5+ years Over the age of 21. UHC has used the 40+ for 5+ years to deny me over and over. Finally made it through all internal appeals and went to external appeal. I hope I hear this week the final answer. My fingers have been crossed for 5 months now. I just hope the external review does see this as medically necessary... I have UHC and kinda on the same road as you. My plan requirements don't specifically state I need a BMI of 40 for last 5 years but a "doctor diagnosis of morbid obesity".... UHC got some info wrong on my denial letter of the right BMI's for me so I'm now fighting with an advocacy case manager from my employer. I hope to hear what the next steps are by Friday. I did not have a 6 month diet requirement. I've heard it's either 6 months of diet OR 5 years of weight history 40+. Don't rely on the CSR's.... mine couldn't tell me the specifics under my "Summary Plan Description" and I didn't find these out until AFTER I got my denial letter from UHC. It's so crazy how it works. I had called at least 10 times asking for criteria. Share this post Link to post Share on other sites
NIKIMAC 19 Posted December 2, 2012 Sorry forgot to let you guys I had the lap band fir 7 yrs. got it removed 2 yrs ago. Hopefully that will count. I had a lapband for 5yrs, I just had a revision to the gastric sleeve back on Nov 1st. It took UHC 14 working days to make the decision to approve my surgery. My BMI was only 31 with no comb. But I was having issues with my band and it had to come out, but I requested the sleeve so I wouldnt gain my weight back. Share this post Link to post Share on other sites
lexi710 8 Posted December 2, 2012 I have United Healthcare and did not need the 6 mos diet. I provided everything else requested and was approved on the first submission within 4 days. I am now 2 weeks post op. Good luck and happy to help with how I documented everything. 1 1happyloser2b reacted to this Share this post Link to post Share on other sites
ttammara 11 Posted December 6, 2012 Today is a great day!!!!!! My papers went to the insurance company 7 days ago and today I found out it was APPROVED! 3 rocionelizalde, DreamsOfSkinny and MzFree-Spirited Vsg reacted to this Share this post Link to post Share on other sites