insurance pay from lap band to sleeve

[lauriearnold 40]

ive been dealing the UHC since May now waiting to see if they are going to pay for my revision but after talking to them today they said #1 my bmi is only 30 and #2 my insurance will only cover 1 bariatric surgery for lifetime. It's still at the insurance waiting patiently to find out. i guess what i'm needing to know if anyone with UHC had a revision with a bmi less then 35 and UHC cover it???

[BeagleLover 1,020]

I suggest you go to the bariatric coordinator of the hospital you want to attend. They know the rules and have had extensive experience working with them.

[lauriearnold 40]

i am dealing with the insurance coordinator from my surgeons office but my insurance is being a pain in the butt. she's doing all she can and i feel for her cause she's constantly faxing, emailing or talkig to them. i'm tired of eating 300 calories a day, ugh

[BeagleLover 1,020]

I wonder if the person at the insurance company gets some sort of bonus for successfully thwarting a surgery. I've heard UHC is difficult. That's what I have.

[lauriearnold 40]

i they are really being a butt and not getting in any hurry. glad this isn't an emergency yet!!! that's what i'm afraid of, they're going to wait so long and i'm going to be in the ER having major surgery over this when it doesn't have to be.

[DwindlingJen 10]

I have a different insurance but I think so many of them are trained to be negative nellies Keep fighting! Those companies bank on the people that give up right away. It's not easy, that's for sure. I had to fight with mine (Humana) for an entire year. They had me jumping through hoops, resigning the same forms...in fact they would lie to my face and then deny they'd said certain things. My point is that it can be a hard slog but if you don't give up you'll win in the end!

[BeagleLover 1,020]

I have a different insurance but I think so many of them are trained to be negative nellies Keep fighting! Those companies bank on the people that give up right away. It's not easy, that's for sure. I had to fight with mine (Humana) for an entire year. They had me jumping through hoops, resigning the same forms...in fact they would lie to my face and then deny they'd said certain things. My point is that it can be a hard slog but if you don't give up you'll win in the end!

... that's why I don't talk to them on the phone about important issues. Send a letter certified mail, return receipt requested. They'll have to sign for it. The receipt comes back to you. It's not foolproof... you don't have any real proof of what was inside.

[lauriearnold 40]

thank you so much you guys for all your information. i'm not gonna give up yet!! i'm going to keep on until they get sick of me

[DwindlingJen 10]

The certified mail idea is pretty genius! Wish I'd known you a year ago

[luv.is.patient1 0]

Hi @@lauriearnold did uhc finally approve you for the revision? Also what type of UHC insurance policy do you have?

[lauriearnold 40]

luv.is.patient1 NO, insurance denied both appeals so i'm having revision on 11/3 and i am going to be self pay for sleeve but insurance will pay to have removed. I'm going to end up owing $16500

[luv.is.patient1 0]

@@lauriearnold, if I might ask what UHC policy do you have?

[lauriearnold 40]

i have the big total premiere package luv.is.patient1 and they still won't pay it. i've put in 2 appeals and they still denied it. They said that insurance will only pay for 1 bariatric surgery per lifetime. They will pay for the band to come out and everything that comes with it but i have to pay for the sleeve myself and anything that happens after that, that has to do with the sleeve they will not cover.

[Jersrose43 837]

Remember the policy on this is set by employer. You may have same uhc policy but diff employer likely a different rule. All about what the enployer wants to pay

[km30381 2]

I will be going through this very soon. Ins has approved the removel of my band but Dr. doesn't like doing the revision at the same time so we will have to wait to see if Ins will approve a sleeve a few months down the road. The band worked for me so my BMI will not be high enough. I am removing it due to a slip. I have UHC SignatureValue HMO,. I am seeing the Dr. this week to see if we can do both at the same time. Maybe ins will be more likely to cover. Would love any advise or input.

Thanks