United healthcare choice plus.

[melissa1104 5]

hey! I'm thinking of making the leap and getting the sleeve. was originally going to get the band but after really reading about both decided the sleeve is the better option for me. i have united health care do you think they will cover my surgery? i do have a BMI over 40

[READY4CHANGE2013 88]

I have UHC as well and you must have a BMI of 35 and 2 co-mobidities and you must complete a 6 month supervised died. I would call and check with them though becuase every plan is different (my plan didn't have any restrictions). GOOD LUCK!

[melissa1104 5]

Thank You!!

[ribearty 544]

hey! I'm thinking of making the leap and getting the sleeve. was originally going to get the band but after really reading about both decided the sleeve is the better option for me. i have united health care do you think they will cover my surgery? i do have a BMI over 40

Hi, I have UHC Choice Plus through my employer. The first thing you should find out is does your employer cover weight loss surgery. Some companies do not cover it. When I first started working for my current employer, they did not cover weight loss but now do so.

The requirements per the contract my employer has with UHC is a BMI of 35 to 39.9 with at least one comorbidity like high blood pressure, diabetes. There are several of them but these are a few examples. If you have a BMI greater than 40 they do not require any comorbidity. My insurance also requires a 6 month medically supervised diet and a psychological evaluation before they will approve you. UHC works with a company called Optum. If you log into myuhc and go to benefits and coverage and click on special services you might be able to tell from there. Your doctor's office will call your insurance co. to verify coverage. When I called Optum to ask the criteria I was told I would hear back from a nurse in about three weeks and I heard back exactly at the three mark timeframe. She sent me an email with my company's exact criteria I needed to qualify. The number for Optum is 1-888-936-7246. I have seen other post here that their employer does not require the 6 month diet. The previous poster said her insurance requires 2 comorbidities with a BMI between 35 and 39.9. It is all contingent upon what your employer agreed to when they obtained their insurance. If it is not covered by your employer, this would give you time to contact your HR department or benefits department to see if this might be something they may add when they renew their insurance for 2014.

I hope this helps you.

[lindypops 1]

I also have uhc choice plus. I got approved and date set for sept 24th. I have a $200 ded and 1k max out of pocket. Coverage is 95%. I layman terms.... Max cost to me is $1200. That does not include perscriptions or food.< /p>

[wasabi 57]

My BMI is right at 40 and I got approved after the following (no 6 month wait):

Cardiologist clearance

Gastroenterologist clearance

Psychiatrist clearance

Blood test

Stress test

EKG

ECG

Fluoroscopy and chest x ray

Gall bladder and liver ultrasound

Nutritionist Clearance

This all took me about 2 months to get done, and 1 week wait after submittal to insurance. I have UHC Choice Plus.

[wasabi 57]

Oh and they cover my surgery 100%. But I have already met my deductible and out of pocket max for the year. If not it would have been 90%. The psych clearance was not covered either which is weird since I see a psych regularly anyway.

[melissa1104 5]

Thank you all so much for your insight. i'm going to call monday and see..keep your fingers crossed!!

[KevinHagberg 1]

hey! I'm thinking of making the leap and getting the sleeve. was originally going to get the band but after really reading about both decided the sleeve is the better option for me. i have united health care do you think they will cover my surgery? i do have a BMI over 40

Be sure to check your individual plan. Your employer MAY have the option of not including certain procedures. This is particularly true if your employer is self-insured and United Heathcare is simply administering your employers plan. Do your homework and tak with your employer's Benefits Manager.

[SpecialK1960 252]

I am United and they were the best. I have sleep apnea - so that helps. Any secondary condition will really help to push you over (apnea, high blood pressure, diabetes, heart conditions - any weight related co-morbidity will help a lot) I went from 1st appointment to surgery in 22 days (a great doctor and efficient and an experienced staff helped).They covered at 100% (after deductible and $2500 out of pocket ) But be aware that United is a huge company that offers all kinds of benefit packages to employers. My wife and I both have United with very different coverage. Different deductables -- it is all based on the package negotiated with the employer. So although I had an awesome experience, it may be different for you based on your plan. As a company though - I was impressed x10

[NMJG 1,266]

I have UHC Choice Plus. The coverage varies from employer to employer, though. I was not required to do any diets pre-op. My employer required 40 BMI with no comorbities or greater than 35 with at least one comorbidity. Once I got through all the doctor's stuff, psych eval, etc., it took 3 weeks for approval from UHC.

[LBD 121]

Not sure about the specifics of your personal UHC Choice plus plan, but my experience so far has been good. My coordinator was able to get clearance pretty quickly, I only had to have one appointment with the nutritionist, vs 6., so once I've finished all my dr apps & tests I should be able to get final clearance and will have surgery in late September, early October. I only started with this process 3-4 weeks ago. I do have a deductible to meet, but once that's met, the bulk of the cost of the surgery is paid for. Good luck!

[melissa1104 5]

i spoke with insurance this morning..she said they will cover it depending on the codes the doctors use for billing..good news!

[ribearty 544]

i spoke with insurance this morning..she said they will cover it depending on the codes the doctors use for billing..good news!

That's great news. Have to be sure the doctor's office uses the correct codes. Do you have any supervised diet criteria? Mine has a 6 month.

[melissa1104 5]

well my happiness has dwindled...they called me back and said they made a mistake i do have an exclusion for wls

they said they can see if i have a hiatal hernia which they say 95% of patients do..if thats the case the price would drop to 5,000. i'm so bummed out now!