United Healthcare Tricare....need help!

[sarcruze 24]

So I have two insurances. My primary is United Healthcare Tricare Standard and the other is United Healthcare Community Plan. Does anyone have UHC Tricare and have u recently had the vsg surgery? I know tricare west recently changed to UHC and there has been some changes to the policy. Did u have to do the 6 months of weigh ins before u were approved? I checked the UHC tricare website and it does not say how long I need to have weigh ins. These are the requirements:

So if anyone has had the sleeve with UHC Tricare Standard I would love to hear about it. I have called my insurance company and asked what are the requirements but they just say I need authorization and nothing else.

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[KristenLe 5,979]

Do you have a surgeon yet? If so - it's easier for the insurance coordinator to get details. I wasn't able to get info on my plan either.

[sarcruze 24]

Do you have a surgeon yet? If so - it's easier for the insurance coordinator to get details. I wasn't able to get info on my plan either.

My PCP has sent in an authorization to my insurance company to see if I can start the bariatrics program. As of now I do not have a surgeon.

[LoseItKacy 347]

I had tricare for my surgery. I had a bypass tho. My program required 3 monthly weigh in visits before they would even send my stuff to tricare.... I got approved about a week after my stuff was submitted. Had my surgery 3 weeks later. I can't tell you how many times I freaked out worrying about if they would approve my surgery because they weren't specific, and everytime I called I got a different answer. Sometimes they said I don't need any monthly visits and one time I called and they said 9. I technically had 3 and tricare standard approved. So hopefully you have the same luck as I did. They pretty much covered everything.

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Edited July 22, 2016 by LoseItKacy

[sarcruze 24]

I had tricare for my surgery. I had a bypass tho. My program required 3 monthly weigh in visits before they would even send my stuff to tricare.... I got approved about a week after my stuff was submitted. Had my surgery 3 weeks later. I can't tell you how many times I freaked out worrying about if they would approve my surgery because they weren't specific, and everytime I called I got a different answer. Sometimes they said I don't need any monthly visits and one time I called and they said 9. I technically had 3 and tricare standard approved. So hopefully you have the same luck as I did. They pretty much covered everything.

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Thank U @LoseItKacy....When you had the surgery was Tricare Standard with United Healthcare? I know a lot of people with United Healthcare insurance said they had to have 6 weigh ins but I wasn't sure if it would be different with UHC Tricare or the same. How did you eventually find out how many weigh ins you needed?

Edited July 22, 2016 by sarcruze

[LoseItKacy 347]

I think it's different. I just did the minimum that my program required. Tricare approved but they never said how many months they required. So my program just kinda guessed. Since they never gave an exact number our plan was if they denied me the first time they would have to say how many months they required in the reason for the denial and we would go from there. I don't think they care too much about numbers as long as they see you have made previous attempts at weight loss and meet the physical requirements to have the surgery.

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[sarcruze 24]

I think it's different. I just did the minimum that my program required. Tricare approved but they never said how many months they required. So my program just kinda guessed. Since they never gave an exact number our plan was if they denied me the first time they would have to say how many months they required in the reason for the denial and we would go from there. I don't think they care too much about numbers as long as they see you have made previous attempts at weight loss and meet the physical requirements to have the surgery.

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I called my insurance company and the agent told me that my authorization was approved on the 20th to start the bariatric program. He gave me my approval number and told me my servicing dates are from 7/20 - 1/16/2017. Did u Tricare ever tell you when your dates were? That must mean then I don't have to do 6 months of weigh ins if I have until the middle of Janruary 2017. Heres to wishful thinking lol