United Health Care of Florida Approves

Terrilen · October 2, 2005

Thank goodness I had UHC, they took their time but they fianaly approved my band!! My Dr. says in his seminar that unless you have UHC in Florida you can just about bet you will have to self pay. Thank God I had UHC!!!!!

October 14, 2005

Well good for you, but my UHC does not cover the lapband. what should I do.

Terrilen · October 14, 2005

Miranda...What should you do? Well just so you know.My policy would not cover the band or obeisety UNLESS medicaly neccesary. Call back speak to someone else and see if this applies to you policy. Also it helps to have a can do attitude....if you think you can't then you are correct!

October 14, 2005

Thanks sweetie, I am going to do just what you said. and thanks again for emailing me right back. I am sending up a blessing for you.

thanks.

miranda

puffyone · October 14, 2005

Miranda,

My advice is that you get at least three different care coordinators "take" on what UHC does and doesn't cover per your policy. When I was having trouble getting a straight answer out of them I followed the advice to keep calling and asking the same question. Low and Behold when I got another rep on the phone I received the correct information. UHC DOES cover the band unless there is a specific exclusion in your policy. UHC DOES cover bariatric surgery when deemed "medically necessary for morbid obesity" unless there is a specific exclusion. The verbiage in these policy documents can be really confusing so your best bet is to call and try to speak with a manager. Even though I was able to get confirmation over the phone that I had been approved, it took twice as long as they said for me to get it in writing and then when I did get the letter it was written in such a way that suggested that the surgery might not be covered. Anyway, once again I called and talked to the care coordination department, asked for a manager and had it all deciphered.

If you have a hard copy of your ins. policy in hand and look for the section titled "exclusions" you should find something referencing weight loss surgery or bariatric surgery. Usually the exclusion language includes some qualification with respect to morbid obesity and medically necessary.

Good luck. Keep me posted. I'll be thinking about you and hoping for success. This time last month, prior to my approval, I doubted that I would ever be in the position to say that I was approved.

Anne (puffyone)

ReneBean · October 14, 2005

And be SURE that you specify MORBID obesity - and be sure that whoever you talk to feeds that into the computer. I got a different answer every time until my company's insurance rep gave us their specific file notation to look up. If they just enter "obesity" the answer will always be no. Nobody covers treatment for that.

:]