newmebithebypass 713 Posted October 21, 2015 so im on month 3 of the 6 month diet required by United Health Care. i gained 1.5 pounds between my first and second month and i wanted to know if i would get denied down the road or if i would have to do more classes or what the protocol would be Share this post Link to post Share on other sites
Bufflehead 6,358 Posted October 21, 2015 It really depends on your policy. What does your plan document say about requirements to be approved for surgery? Share this post Link to post Share on other sites
The Candidate 3,215 Posted October 21, 2015 It does depend on your plan. But as long as you don't end up with a net gain at the end, you should be all right. Share this post Link to post Share on other sites
2goldengirl 2,076 Posted October 21, 2015 I wouldn't worry. The policy is that you adhere to the program, not that you lose consistently, or in fact lose at all. I know in five years, I can't remember anyone denied for gaining on a weight loss program. We can't because the policy doesn't stipulate weight loss, only adherence to a program. I hope this makes you feel better. Share this post Link to post Share on other sites
newmebithebypass 713 Posted October 24, 2015 i does make me feel better and my endo put me on victtoza and ive been losing about 2-3 pounds a week so i know ill show a loss at my next appointment Share this post Link to post Share on other sites
snowflurry321 1 Posted November 15, 2015 Victoza hasn't helped me lose weight at all. I have UHC as well. I have gained and then lost and gained again. We'll see if I get denied I guess. I'm nervous too. I'm on the low end of the BMI and I believe only one comorbidity. Share this post Link to post Share on other sites
newmebithebypass 713 Posted November 17, 2015 well i went to my 3rd nut appointment it showed a 4 pound loss so yay. and @@snowflurry321 where are you having surgury Share this post Link to post Share on other sites
snowflurry321 1 Posted November 18, 2015 I'm in California. I will be at Memorial Hospital in Modesto if all goes well. The countdown continues. I just had my month 4 appointment so 2 to go. Share this post Link to post Share on other sites
Nora82 11 Posted November 24, 2015 Most insurance companies require that you have the same weight or lose weight during your monitored. As long as your at or below your original weight by the end of the 6 months you should be fine. Share this post Link to post Share on other sites
southernbelle256 101 Posted November 24, 2015 I had a significant gain and was approved with BCBS. Share this post Link to post Share on other sites
snowflurry321 1 Posted November 24, 2015 Nobody I know has been denied because of a gain. As long as the were strict about adhering to the monthly visits with a Dr. They were good to go. Share this post Link to post Share on other sites
lmc79 1 Posted November 24, 2015 Does anyone have united health care Oxford...liberty plan? I am going for my first appointment at the bariatric office and was wondering if my insurance plan covers this surgery Share this post Link to post Share on other sites
newmebithebypass 713 Posted November 28, 2015 well heres another hiccup int eh plan my insurance through my dads work is switching to bcbs anthem and i have to wait til monday to find out if they will even cover the damn thing im so stressed im so worried i have state insurance that will cover it but i dont know if it will be at 100% because they are my secondary and im just a ball of worry right now Share this post Link to post Share on other sites
Nora82 11 Posted November 28, 2015 If your primary does deny it your secondary will cover it all except your out of pocket. Hopefully your primary will cover it but if not you still have hope ???? Share this post Link to post Share on other sites
newmebithebypass 713 Posted November 28, 2015 Yes I do have hope I am blessed to live in a state that requires Medicaid to cover it as a medical necessity Share this post Link to post Share on other sites