United Health Care Insurance

[snarkysheltie 1]

Thank you SO much, this is immensely helpful!!! I have UHC and like Mandybb I had to enroll in the bariatric program. I've just begun the process though, my first phone consult with the bariatric nurse isn't for 3 weeks. No one has said what weight they go by, though....if I drop below 40 during my 6 month required dieting, will UHC deny me? I'm worried.

[Sleeve1stFitNext 924]

7 hours ago, snarkysheltie said:

Thank you SO much, this is immensely helpful!!! I have UHC and like Mandybb I had to enroll in the bariatric program. I've just begun the process though, my first phone consult with the bariatric nurse isn't for 3 weeks. No one has said what weight they go by, though....if I drop below 40 during my 6 month required dieting, will UHC deny me? I'm worried.

Talk to your surgeon about it. Do you have any comorbidities? This would help you.

[snarkysheltie 1]

I don't have a surgeon yet....about the only thing I've done is pass the verbal pre-screening to join the program and schedule my first call with the bariatric nurse. I DO have high bad cholesterol and low good (I forget which is which), and sleep apnea. I know this isn't a comorbidity, but found out today I will be having a knee surgery April 3....and I know that it is partially due to my weight....so I gotta lose it so I don't need the other done. Hopefully that will be a contributing factor for approval.

[Bobcats 3]

Hi Thejeweledsleeve and thanks for your detailed description of the process through UHC. I have just begun the process through them, although UHC in my state of Florida seems to run their bariatric program through Optum Health Complex. I just met the requirements for BMI without a comorbidity at 40.7 (they want 40). I actually went through the 6 month consultation with my primary care physician in 2015-16, so hopefully I won't have to do this again. I initially lost 35 lbs and got down to a BMI of 38.4, but my weight went up 12 lbs from Sept 2016-March 2017.

My question is, since I am on the line between qualifying and not qualifying, once I start the program, can I be denied the possibility of surgery for losing weight? How does this work?

[Sleeve1stFitNext 924]

33 minutes ago, Bobcats said:

Hi Thejeweledsleeve and thanks for your detailed description of the process through UHC. I have just begun the process through them, although UHC in my state of Florida seems to run their bariatric program through Optum Health Complex. I just met the requirements for BMI without a comorbidity at 40.7 (they want 40). I actually went through the 6 month consultation with my primary care physician in 2015-16, so hopefully I won't have to do this again. I initially lost 35 lbs and got down to a BMI of 38.4, but my weight went up 12 lbs from Sept 2016-March 2017.

My question is, since I am on the line between qualifying and not qualifying, once I start the program, can I be denied the possibility of surgery for losing weight? How does this work?

Well, it all depends on your insurance and what they expect. Some people fall under the BMI limit during the diet but not enough to be disqualified. My suggestion is reach out to the insurance company as well as speak with the Bariatric center. They would be better able to give you an insight on how things would work out.

[Sleeve1stFitNext 924]

On 2/24/2017 at 7:21 PM, snarkysheltie said:

I don't have a surgeon yet....about the only thing I've done is pass the verbal pre-screening to join the program and schedule my first call with the bariatric nurse. I DO have high bad cholesterol and low good (I forget which is which), and sleep apnea. I know this isn't a comorbidity, but found out today I will be having a knee surgery April 3....and I know that it is partially due to my weight....so I gotta lose it so I don't need the other done. Hopefully that will be a contributing factor for approval.

High Cholesterol counts, sleep Apnea counts. Having to get surgeries on bones can also help. It depends on how the doctors explain it to the insurance company when they submit the paperwork.

My surgeon used the fact that I had surgery on my foot to help me with getting approval.

[nikki1977 0]

im new here and i have uhc but im trying to get approved for a revision from a sleeve to bypass due to gerd and hernia . my question is will i have to go thru the 6 month evaluation again like i did for the the sleeve

[FabNFit@40 52]

Do you know if they require a 3 year weight history with BMI of 35 with a comorbidity or over 40 with out to qualify?

[Chrysaia 6]

Does anyone have United Healthcare's HDHP plan? Does it still cover bariatric surgery?

[courtneylosing 17]

Thought I would add on to this post. I have UHC and I did not have to do an EKG or an ultrasound. I also didn't have to keep records of my food or exercise.

I did have to do 6 months worth of supervised dieting. I had to have a psych evaluation. I did have to do a endoscopy. My final appointment with my surgeon was to answer final questions. I was told approval/denial would be sent within 7-10 business days from UHC. It took them exactly 9 business days for an approval.

I did NOT have to lose a specific amount of weight beforehand and actually gained from my first appointment 6 months ago and still received an approval.

I'm located in Texas and could be different depending on which plan you have UHC. It's been a painless process though. Surgery is scheduled for June 12, 2017.

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[courtneylosing 17]

Do you know if they require a 3 year weight history with BMI of 35 with a comorbidity or over 40 with out to qualify?

I have UHC and they didn't require it.


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[Beijaflor 3]

Hi Thejeweledsleeve and thanks for your detailed description of the process through UHC. I have just begun the process through them, although UHC in my state of Florida seems to run their bariatric program through Optum Health Complex. I just met the requirements for BMI without a comorbidity at 40.7 (they want 40). I actually went through the 6 month consultation with my primary care physician in 2015-16, so hopefully I won't have to do this again. I initially lost 35 lbs and got down to a BMI of 38.4, but my weight went up 12 lbs from Sept 2016-March 2017.
My question is, since I am on the line between qualifying and not qualifying, once I start the program, can I be denied the possibility of surgery for losing weight? How does this work?

Did you meet with your doctor every month for your six months? I'm curious to know if they have any flexibility in the approval process if you qualify otherwise.

[azgirl2 0]

im new here and i have uhc but im trying to get approved for a revision from a sleeve to bypass due to gerd and hernia . my question is will i have to go thru the 6 month evaluation again like i did for the the sleeve

Did you have the revision. I'm trying to get revised from band to sleeve and have United Healthcare as well

[nunezy 5]

How long after approval was surgery schedualed???

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[nunezy 5]

And who here has united health care community plan???

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