Insurance approval?

[marley3 8]

Just had my consult today. Does anyone have experience with United health care? Just wondering if getting approved is going to be a long process? Thanks

[craftygal77 22]

Community plan or through your employer?

[marley3 8]

Employer

[taweedeegirl 68]

6 months of nutrition ... psych..

I was approved by them

[kyboo1972 90]

I had united through employer...but had a clause of no bariatric surgery coverage. I would have had to appeal.

[ivettegza 0]

@@taweedeegirl - did you lose any weight during the 6 month nutrition portion? I wonder how strict they are with that part. I have coverage with United Healthcare through my employer and currently going through the 6 month process. Haven't been successful in losing any weight though. I have actually gained 4 pounds.

[marley3 8]

Were you expected to lose weight during the six months?

[ivettegza 0]

Well as far as my doctor is concerned, no I don't have to lose weight. The only reason I have to wait the six months is because its an insurance requirement to follow a nutrition plan for 6 months and have a psych eval to get approval. I don't know how strict United Healthcare is with that six month deal though and if they do expect people to lose weight or not... that is why I was curious to find out from someone who has already gone through the whole process with them. When I spoke to my case manager (from UH) a few weeks ago, I asked her she thought I would be denied for not losing any weight. She said she didn't think so, but the "think so" part has me doubting...

[Champ715 207]

I had United Health Care through my employer and was required to do 6 consecutive visits with a nutritionist and the psych evaluation. My surgeon's office has a bariatric insurance coordinator who told me that I would be disqualified if my BMI dropped below 40 at any point during the 6 months of visits. She basically explained it this way: the insurance company wants to find any reason to deny coverage for the surgery so if they see that you lost weight with just diet and exercise, they'll say that you don't need surgery to lose weight. I started with a BMI of exactly 40 so I had to be careful not to lose even an ounce during the 6 month visits. I actually ended up gaining 3-4 lbs throughout the six month period.

It seems like all policies and clauses are different so this may not be the case for you. I just wanted to make sure I passed on my experience because I'd hate for someone to get half way through with their 6 months, lose a pound, then be disqualified and have to start all over.

[marley3 8]

Thank you!! Something to remember!

[taweedeegirl 68]

I agree with Marley.. I actually put on weight prior to starting visits.. to ensure my BMI wouldn't drop too low. I didn't lose a pound.. and I was approved

keep in mind your BMI should be 35-40 w/ co-morbidities

without co-morbidities 40 or higher

[marley3 8]

I have high cholesterol and rheumatoid arthritis. Would those count?

[taweedeegirl 68]

not sure if those count.. high cholesterol might??