Uhc

[MS_mom_1965 0]

Who here has UHC? Are they pretty strict about the 5 year obesity requirement? Do co-morbidities override that?

I had posted this on the Insurance thread, and I'm hoping to get more response here...

[barbara465 2]

I didn't have a problem. I didn't have my PCP do anything. They took what the lapband doctor submitted which was my chronicle of all the things I tried. I don't think you have to prove you tried all the different weight loss methods, just list them. Not sure about the 5 years of obesity. I think if you have co-morbidities that should be enough.

Good luck.

[Bullwinkle 1]

From what I've found out about UHC so far, there are myriad UHC policies.

Some are quite liberal, while some are quite strict. Some have exclusions that your employer imposes, some don't.

It really all boils down to one call from you to your insurance company. That's what I did, and found out right away that my UHC didn't cover ANY kind of WLS.

My husbands UCH policy, on the other hand, covers WLS plus SOOOOOO many other things. He is in a very, very large group. Mine is small.

Hope this helps.

[skyeblu79 0]

From what I've found out about UHC so far, there are myriad UHC policies.

Some are quite liberal, while some are quite strict. Some have exclusions that your employer imposes, some don't.

It really all boils down to one call from you to your insurance company. That's what I did, and found out right away that my UHC didn't cover ANY kind of WLS.

My husbands UCH policy, on the other hand, covers WLS plus SOOOOOO many other things. He is in a very, very large group. Mine is small.

Hope this helps.

I have UHC and mine is really strict too...They will not cover any WLS.

[losingjusme 12]

i have UHC and was approved in less than 2 weeks. :thankyou:

i did not need any testing other than a blood and ekg ... however, i am a big girl ...

good luck!

[Molliegirl 0]

I have UHC and called them way before I even made my first appointment. It was covered. They didn't even ask me any questions. The surgeon's office submitted all the paperwork and submitted all my medical documentation from the tests I had. I also had to fill out the history report and of course, like many others here, for the last 20 years or so, I tried ALL the diets with no permanent weight loss. Always gained it back. I did find out I had sleep apnea along with the existing asthma condition. All was covered 100% (since they were participating in UHC plans) except for the nutritionist and the psych evaluation. I would love to know what they submitted, but I guess that is moot now, since all was approved and I have now had my band for a year this month. I am 5 lbs from goal and would do it again in a heartbeat!!

[cootie 0]

UHC too, was approved in less than 2 weeks. No co-morbitites either.

[Wheetsin 714]

I have a "special" UHC EPO. I did not have comorbidities and did not have to submit a supervised weightloss effort. I don't know about a 5 year obesity requirement. Wasn't a problem for me, as that was documented in my medical records.

[Momotrips 0]

According to all of my doctors' staff, UHC is the best insurance with which to work and easiest from which to collect. Yes, there are many different policies, but WLS being covered or not is usually a stipulation of the employer, not UHC. I believe a company's policy is cheaper if they don't allow it. (Same with infertility - I got lucky on that one too. My former company changed the policy the MOMENT I gave birth! Hee!). I had no problems at all. I contacted all of my doctors and had them send my records to my surgeon, the surgeon's staff packaged it in the way UHC requests and off it went. My only snag came in that it floated around the UHC office longer than I would have liked. UHC was willing to let me get the surgery with just a phone call from my surgeon's office, but they preferred to get the official approval by letter. My surgeon loves to work with UHC - he has you pay the estimated difference up front and then they deal with UHC for the rest. Simple. I paid $600 out of pocket and may or may not get some of that back. Haven't gotten the hospital or anesthesiology bill yet, though. You never know with that stuff.

I had a 39 BMI and co-morbidities. They ask for proof of a doctor assisted diet, but apparently it isn't really required. Especially since I checked off 95% of the list of recognized diets on the questionnaire for my surgeon! It was easier just to mark out the ones I hadn't tried!

Good luck. Call UHC and ask them what your policy covers. I called one day just out of curiosity (and being sick and tired of being fat) and they said yes that I was covered! It all started from there.