Conflicting info on UHC medicaid

[kelsbelles 4]

I called my insurance company (UHC TX medicaid) and was told the only requirement is a letter of medical necessity. I called 3 different times to make sure I got the same answer. When I went to my consult, the benefits coordinator said I will need 6 months of supervised diet. She said we can try and submit it early to see if it will get approved. Which info is right?

[merry1126 42]

I have United Healthcare Community plan (medicaid) from NY. I found this policy during my research last year. Unless there has been a change, the requirements are six months, pysch eval, BMI >40 or >35 with comorbidities.

https://www.unitedhealthcareonline.com/ccmcontent/ProviderII/UHC/en-US/Assets/ProviderStaticFiles/ProviderStaticFilesPdf/Tools%20and%20Resources/Policies%20and%20Protocols/Medical%20Policies/C&S/bariatric_surgery_CS.pdf

Hope this helps, best of luck.

[newmebithebypass 713]

i have uhc through my dads employer and they require a 6 month monitered diet and a psych eval and a bmi over 40 or over 35 with 2 comorbities

[kelsbelles 4]

It's so odd that the insurance told me something different. Either way I'm prepared to do the 6 month diet. 1 month down!

[alainagirl 4]

Hello I have uhc community plan also the lady who I talk to throw the insurance said the same thing your did she was wrong. My friend has the same one I do same surgeon she just got her surgery done 6 months supervision. The surgeon told me the same thing . I Googled the requirements for uhc bartiatrics Sugery and it said 6 months all the requirements. So all said and done that's the deal it's been 2 months already it does go by quick because of all the things u have to do .faster than I thought. My date is 4-5-16 . They told me 2 weeks before that date they submit my letter medically necessary and all the other info . That woorries me . always some kind of BS. Hope some of this info helps u. Good luck to ya.

[craftygal77 22]

I have UHC Michigan Medicaid. I started this journey with a consult with the surgeon and their insurance coordinator told me that I need to go through a one year medically supervised diet. I know it's a long time but it is helping me get ready, I'm about 8 months in. At one point I called UHC to check the requirements and they told me there is no required supervised wait time. I didn't understand what she was saying so I called the insurance coordinator at the surgeons and she reassured me that yes, there is a 1 year wait for me. I'm very nervous with anxiety about being denied when it's submitted. Did anyone have to lose any weight before surgery? Have you heard on anyone getting denied even with appealing it? Thank you, and good luck to you all!

[2goldengirl 2,076]

I don't know about your prticular plan, but your surgeon's office gets approval for many, many surgeries each year. The person answering the phone at an 800 number gets questions about everything. I'd think the insurance coordinator at your surgeon's office has good information - they do this all day, every day.

Good luck!

[marleneb 6]

Hello,

I found out the women at my surgeon's office knew everything about uhc they deal with them all day aswell. You have to have all the requirements done before they can submit the info to get approve.they just want you to do 6 months insurance I don't think any sooner I just don't want to push it even if I finish all the requirements early there has to b a reason for this 6 months.some doctor appointments take 2 months to get they want u to b prepared for this life changing experience. I know it's going to b quite different and so many things we couldn't do that we will bable to. That is going to b great to run around with my 6 year olds twins and not b out of breath! ! Healthier just amazing the story I've heard and the things that I'm learning blessed truley.

[kelsbelles 4]

I'm prepared to do the 6 months of diet. My doctor went on maternity leave, so I had to see a new doctor who wants me to try a few things before he gives me a letter of necessity. Plus it's just hard fitting in these doctor appointment all on! I've got 2 months down, so another 4 won't be bad!

[TristanNicole 169]

I have united healthcare choice plus thought my dads employer. My requirements were the same as everyone has mentioned. I also had to register for United healthcare's bariatric service, has no one else had to do that? I had a call with a nurse case manager who basically just talked to me about the surgery and asked me some questions about my plan and support ect. She also called me about 5 months in to see how everything was going and she also called a few days after surgery to check on me. (She wasn't from my surgeons office she was from the insurance). They also sent me some booklets at the very beginning.

[newmebithebypass 713]

@@TristanNicole i have the same thing the nurse from the insurance calling to chat with me about the surgery i love my nurse she is super positive

[Tosha-248 21]

Good luck to everyone it will be well worth it

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[gina171 626]

I don't know about your prticular plan, but your surgeon's office gets approval for many, many surgeries each year. The person answering the phone at an 800 number gets questions about everything. I'd think the insurance coordinator at your surgeon's office has good information - they do this all day, every day.

Good luck!

My surgeon's office was wrong, said I had a 6 month wait BC I was UHC. They didn't understand that UHC just administrated my husband's company's self-funded health care plan. I asked them to pls call and check. No wait.

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