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United Healthcare Denial?



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I am sure by the time I may or may not need a letter, this thread will be long and this post will be lost so will you please send me that letter just in case i need it? My email is kc.ronda@yahoo.com. Thanks for your help, I got to thinking, I did visit my OB/GYN once a year so I can get the info there.

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:thumbdown:Just got a call from the doctor and my policy with United does not carry any form of weight loss just as I suspected. Off to Weight Watchers I go!

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Hi all, I know this thread hasn't been active in a while but I'm pretty new (ok really new signed up yesterday lol) and I have UHC. I just want to know if anyone elses benefits said the same thing and then something else came up that they need (6-month diet or the 5 year weight history). This is what my insurance broker sent to my HR manager, it's straight from the manual:

13. Obesity Surgery

Surgical treatment for morbid obesity when provided under the direction of a Physician when medically necessary as determined by us.

Surgical treatment of obesity when provided by or under the direction of a Physician when either of the following criteria is met:

The Covered Person must have a Body Mass Index (BMI) of greater than 40. The Covered Person must have a Body Mass Index (BMI) of greater than 35 with complicating co-morbidities (such as sleep apnea or diabetes) directly related to, or exacerbated by, obesity.

I just want to be prepared so that I can get anything I need together asap. I was told that after I had my nutritionist evaluation and surgical consultant that's when the insurance coordinator would submit everything for approval.

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I have UHC and had no problem with approval. I had my diet history for the past 10-15 years of ups and downs in weight loss. My BMI was over 40 and I had no co-condiitons. I was approved first time out. I needed to do nothing else for the insurance company . However, I had to do lots for the doctor (ie sleep study, psychologist etc.) I first saw my doctor on September 14 2008 and had the surgery on November 6th 2008.

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I did have to have 5 years of history and 6 months in the last year (didn't have to be in a row) someone else on the same plan as me same Dr. has to have his in a row. Seems they change/apply the rules randomly.

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