UHC Choice Plus

[Asmith0506 1]

I have UHC CP and trying to find out what the requirements are to be approved, I know its covered with COE. But just wondering how everyone found out what their insurance requires as far as 6 month supervised diet 5 year history etc. I called UHC and she said that it didn't say and I had to call the Dr. but its so hard to get in contact with them, when i first looked into this i was going to go to a Dr locally they immediately checked my qualifications and told me it had to be a COE which they weren't. I scheduled a seminar on the 28th and she said there they will get insurance information and what not but i don't want to drive an hour to a seminar if I don't meet the qualifications. Long story short how did you find out what your insurance requirements where. lol

[blondiebabs 214]

I have Aetna, and its like pulling teeth to find the qualifications on the website, it says over and over that they do not cover WLS everywhere, however I knew that was not true. I searched "weight loss surgery" and nothing came up, tried a couple of other things, finally I just typed in "sleeve" in the main search bar of the member's website and it pulled up all the requirements as a PDF file. It looked like something that is sent to providers. Try logging into their website and searching for the information using different key words, if you haven't already. It is a pain that they act like the info is top secret.

Also, did the hospital or wherever you are going for this seminar get pre-approval from your insurance that it would be a covered benefit as long as you provided all of the required documentation? If you are not sure I would call and ask them. Mine asked me a series of questions about weight, age, etc and got pre-approval before they booked me.

[SherB 220]

I have United Health and they required a 6 month supervised diet. I chose to go with the group that was affiliated with my surgeon. I would be careful to stay under a doctors care. I didn't have to have 5 years of weight background. My bmi is over 40 so I didn't have to have further tests for sleep apnea. I was also required to go to a Center of Excellence. Do not bother going anyplace else, it is a waste of your time. In order to be a COE you have to have super high success rates and super low side effects such as leaks etc. I feel in safer hands that way. Contact a COE and have them contact your insurance company. I hope this helps.

[jhood2005 17]

I also have UHC Choice Plus, I had to call their bariatric nurse case manager, In my covered benefits under other services it had a column for bariatric and it had a number to call, I left a voice mail and a case manager called me back and has been working with me all the way, she told me where the centers of excellence were around my area and all the criteria I had to meet, the insurance waived the nutritional visits but I have to do 8 coaching visits with their person from the insurance referral, I had to do the initial doctor visit first, then the pre op class, then psych eval, and now the 8 coaching visits, the insurance case manager helped me with all of this and has been wonderful, she works with the case manager assigned to me from the center of excellence and they work together.

[Luvin_Life125 558]

You can also try searching on the united healthcare website "coverage policy bariatric surgery". I also recommend using the provider search and search by type and type in "center of excellence bariatric surgery". Hopefully those search terms will help you find the information you are looking for.

[Asmith0506 1]

I found the benefits online no where did it list qualifications other than 40+ bmi, I called the coe where I will be going and they will not even check my insurance until I attend the seminar, which the whole point in me finding out is so I don't travel over an hour for something that I won't be approved for. When I called uhc they didn't have anything to tell me other than 40+ bmi, one good thing is when I called and talked to the office at the COE they told me that if they aren't saying anything else then they may not require anything else. I guess the only thing that I can do is go to the seminar give them the information and then wait to hear what exactly the insurance requires.