UHC Choice plus-won't cover?

[Bikergirl 0]

Per the website, bandmd.com your ideal body weight is 108-132. Which means that if they look at the high side (132) you are shy of 100 lbs. overweight by 4 pounds. Your BMI is showing to be 39.1. Hopefully the additional information from your doctor will help. The insurance company should look at this as preventive. If you loose weight - then you will not develope the high blood pressure or diabetes. This will also help with your back pain. Good Luck.:clap2:

pamla68: Yeah, I've found that as well. My BMI is at 39. I think where my confusion lies is what my ideal weight would be, to determine if I'm 100lbs overweight. I'm 5'4 and at 228 right now.

As far as health issues related to the obesity, there's a high risk of diabetes and high blood pressure on both sides of my family.

I've also got some back problems that my doctor said could have been aggravated by my weight. Actually, in my defense, he said he'd supply a letter of proof to my insurance to say that my weight could have been a factor in my pain.

Courtney

[spectacularone 0]

We had a choice of which insurance provider to select with my husband's work. I picked United Health Care because they specifically cover lap band surgery for those with a BMI of over 35. Well, we submitted a pre determination and after 20 days or so, I started to call and check on the status. Each and every day I called they said something COMPLETELY different! One day they said to go ahead and have the surgery since it's outpatient I didn't need pre determination. The next day, they said it was in medical review. Then I finally got a denial letter in the mail that had NO reason stated for the denial! We (my physician and I) are appealing and I'm going through all the hoops of getting my medical records--they said that alone could take 30 days and then another 15 to hear about the appeal and 3 weeks after that for the actual surgery.......this is going to take FOREVER! It's hard to be patient here:)

[ROSIEG 0]

Well, last week on Feb. 20th we checked with the insurance (UHC) and was told no answer yet. However, on Saturday I received a letter dated 2/10/07 saying I was approved. I called the Doctors office on Monday was scheduled for Wednesday (2/28/07)and I am now 4 days post op. So hang in there everybody. Just cautiously believe what your insurance people tell you.

[pamla68 1]

I just found out this was the proper department for status. Did anyone mention that before? Anyway the # is 800-638-7204. The computers are down for the next 2 hours so contact them this afternoon. They were unable to assist me at this time because of the computers.:faint:

[court4short 0]

So, I called the insurance company and they said that with the lap-band I would pay a $1,000 deductable and then they would cover 70%. So, I called the one doctor that was both on the lapband website and my insurance website. Well, the secretary said that she called my insurance and said that the procedure/doctor was out of network, so there would be a $3000 deductable and then 60% would be covered.

I was a little disappointed, and confused, to be honest. But, I made an appointment with the doctor anyway, just to get a more clear idea. Maybe find out a more concrete out-of-pocket figure.

As important as this is to me, price is a big issue. Especially when I've got enough debt as it is.

So, we'll see what happens on the 21st, then.

[bamagirl36526 0]

CONGRATS!!!! I am on my 5th week now waiting for the deniel or approval from the insurance company

Just a update I am still waiting on UHC!!!! I quit counting the weeks...I am so discouraged.....:cry

[pamla68 1]

:banana I'm hot because UHC said they just got my paperwork March 1st! The drs. office said they would send it on February 21st. I know PO box mail doesn't take two weeks.

[cjschultz 0]

It is so weird how the plans are so different. I went to a seminar on Dec. 28, 2006 and was banded on Feb. 19, 2007. My whole process only took a little less than 2 months. The most I will pay is $2250.

Good luck to all still in the process!

[pamla68 1]

It is so weird how the plans are so different. I went to a seminar on Dec. 28, 2006 and was banded on Feb. 19, 2007. My whole process only took a little less than 2 months. The most I will pay is $2250.

Good luck to all still in the process!

I think also it has to do with your employer, whether its choice, choice plus, HMO, PPO, etc..

[Bikergirl 0]

Court4short: Are there any other doctors in your area. I'm not sure what state you are in - but there are several doctors in my state (TX), some in network others out - I of course went with a doctor in network. I also choose him because all he does is lapband (no GB surgeries)

So, I called the insurance company and they said that with the lap-band I would pay a $1,000 deductable and then they would cover 70%. So, I called the one doctor that was both on the lapband website and my insurance website. Well, the secretary said that she called my insurance and said that the procedure/doctor was out of network, so there would be a $3000 deductable and then 60% would be covered.

I was a little disappointed, and confused, to be honest. But, I made an appointment with the doctor anyway, just to get a more clear idea. Maybe find out a more concrete out-of-pocket figure.

As important as this is to me, price is a big issue. Especially when I've got enough debt as it is.

So, we'll see what happens on the 21st, then.

[Bikergirl 0]

Do you think they are getting so many that they are overwhelmed with the claims. I'm glad they got your information. You will be moving to bandland real soon.

:banana I'm hot because UHC said they just got my paperwork March 1st! The drs. office said they would send it on February 21st. I know PO box mail doesn't take two weeks.

[pamla68 1]

Do you think they are getting so many that they are overwhelmed with the claims.

You know, I wonder if they are seeing an epidemic of us? I hope they pass me before they decide to take a second look.:phanvan

[Bikergirl 0]

Any new information from pending approval - That number pamla68 should help some of you - you will need your reference number from your doctor. I made 2 calls to them. I don't think I would be banded right now if I didn't call them - because they approved it but forgot to send the letter.

[pamla68 1]

I have none, I've been too afraid to call because when I talked to them Monday they stated it takes 30 days!:faint:

[bamagirl36526 0]

Just a update I am still waiting on UHC!!!! I quit counting the weeks...I am so discouraged.....:cry

Well today is looking up...I just talked to the doctor's office and they have gotten three approved my UHC Choice this week and that they have not received mine back yet but my case was the same so she told me mine should go through but did not want to discourage me if it didn't....so i am taking this bit of information as a forward step to being banded....Thank you all for listening to me yaw are great!!!!!:confused: