ibhealthy2 5 Posted August 13, 2015 I'm going to orientation tonight. From there. I will get appt with surgeon to get surgery options and then was told will check if insurance covers bariatric surgery... Which I'm told it does. I just want to find out what my out of pocket will be. Also I'm seeing Dr Krahn and Dr Chin in San Bernardino. Was wondering if anyone had been there too Share this post Link to post Share on other sites
CANDI254 31 Posted August 13, 2015 I have United Healthcare also, my out of pocket for the surgery was my out of pocket max (3000). I had a lot of problems getting United to pay for the surgery. They wanted a 6 month diet (which they said I did not have to do at first) then the auth had to be in the system for 6 more months before I could have the surgery. Share this post Link to post Share on other sites
imsoglad56 402 Posted August 13, 2015 I have United Healthcare in Texas and they technically covered bariatric surgery but the restrictions were so ridiculous that I ended up having it done and billed to insurance as a hiatal hernia repair (which was really done) and I paid out of pocket for the sleeve portion of the surgery. Had I gotten the surgery covered under the bariatrics portion of the plan, my out of pocket would have been in the neighborhood of $13,000. The way I had it done instead, my out of pocket total was less than $6,000. Share this post Link to post Share on other sites
Bloomer723 75 Posted August 13, 2015 @CAND1254 was the 6 month after you had already done the initial 6 month requirements? I have UHC too but this is the first I've heard about another 6 months. Not sure I can wait a whole year. Share this post Link to post Share on other sites
jahemenway 40 Posted August 13, 2015 It really depends on your employer they dictate what is covered and how. I also have UHC and I don't have to do a 6 Month diet or plan or anything. Just needed 40 or higher BMI or 35BMI with co-morbidities. Whatever you have to do to play their game is going to be worth it in the long run. Share this post Link to post Share on other sites
teitei636 54 Posted August 13, 2015 I have UHC as well. No problems. Approved on 1st attempt and I have no medical issues on paper other than a BMI > 40 for over 5 years. So my surgeon wrote so nicely that we were trying to avoid medical issues in the future. No appeals, just an easy road. My process was less than 3 months. I got sleeved on July 21, so I haven't seen a bill yet, but we had already met our deductible prior to the surgery. I'm not expecting much of a bill at this point. The best to all of you! Share this post Link to post Share on other sites
ibhealthy2 5 Posted August 13, 2015 Thanks for all the info. I checked with my insurance and they said it's covered but only with authorization from medical group. I just got approved for first step. Insurance company said once approved i would pay only $300 out of pocket with max of. $600 if I had complications. Not bad at all because I was prepared to pay more. I hope I get approved from medical group Share this post Link to post Share on other sites
agalindo17 331 Posted August 14, 2015 I have UHC at first I had to pay $1500 but then it my coverage changed and I only paid $250 to stay one night in the hospital but everything else was cover 100% I also had to do the 6 month monitor diet the physiological approval and go thru the whole blood test to get cleared for surgery! I guess it depends on ur job what kind of coverage u get.. Best of luck Share this post Link to post Share on other sites
Dub 9,922 Posted August 14, 2015 I have UHC and they'll pay 50% if I go through certain doctors and the six month wait. I'm looking into self funding now as a faster option with the surgeon of my choice. Share this post Link to post Share on other sites
momfromjersey22 403 Posted August 14, 2015 I have UHC and they paid 100% Share this post Link to post Share on other sites
PAB3 20 Posted August 14, 2015 Hello...I have UHC through my husbands job in Louisiana...had to do 3 month supervised weight loss program with psych eval and 3 nutritionist visits, one year history from PCP, and some things required by the surgeon. UHC will pay if I have it done by a UHC physician in a UHC facility and my total out of pocket will end up being around $1000 (&250 to meet my deductible, $500 for surgeon and a few other small costs) but my hospital stay will be 100% covered. It took them less than 24 hours after submittal to approve and I will be having surgery on Sept 8 yay!!! I began with a BMI of 40 and truns out I have sleep apnea and elevated liver enzymes...so I guessing thats why such fast approval!!! Check with your UHC to see if there are stipulations about UHC physicians or facilities because at first glance our insurance says they do not cover WLS at all....helps to dig!!! Good luck to everyone!! Share this post Link to post Share on other sites
bls01 8 Posted August 16, 2015 I have UHC and had to do the 6 month monitored diet program. Didn't like the idea of that at first but it went very quickly and did give me time to start to change some things that I would need to change post-op anyway. I think it will make the post-op easier. I just looked at it as an opportunity to grow. They said my estimated out of pocket would be $1500. I have found UHC to be very easy to work with. Am waiting for final approval and then they can schedule my surgery. Share this post Link to post Share on other sites
laguerr13 993 Posted August 16, 2015 Actually it depends on which UHC you have, in Texas I have UHC of Delaware and have the premium tier, so my dietician was only for 3 visits including the pre surgery visit and the letter from my psych doctor Share this post Link to post Share on other sites
Jessica Ellison-Correa 66 Posted August 17, 2015 i have uhc and its through my fathers employer and the requirements were i had to have the insurance for a year a bmi over 40 and be on a medicated diet for 6 months and have a psych test Share this post Link to post Share on other sites