United Healthcare

destiny79 · 10-22-2007, 06:03 PM

what are the requirement for uhc I called them and they said that I am covered but did not tell me what are the requirements such as Aetna has a 5 years weight history and 6 month Dr. exercise plan someone please help before I get my hopes up high my bmi is 42:help:

Shalee04 · 10-22-2007, 06:25 PM

Quote:

Originally Posted by tomecia25

what are the requirement for uhc I called them and they said that I am covered but did not tell me what are the requirements such as Aetna has a 5 years weight history and 6 month Dr. exercise plan someone please help before I get my hopes up high my bmi is 42:help:

I have United Healthcare HRA Plus, thru GAP INC. and I was approved in 1 day. We submitted letter from surgeon, PCP, He stated I have High Blood Pressure and a few other Co- Mobitities. The Nutricionist, The Physc Evaluation. Also and I had to write a letter regarding my weight loss efforts for the past 5 years. I did my letter for 20 years actually. with weights for years and what I did to lose pounds.. with alot of emphisis on the past 5-7 years..... And they approved it in 1 day. My Dr was like WOW Amazing, So as of right now I am scheduled for surgery on Nov. 12th...:whoo:

Kelly

dsmit13 · 10-23-2007, 08:35 PM

<p>I have UnitedHealthcare through a railroad contract and was approved in 3 days. I met their BMI requirement of 40 without comorbidities or 35 with comorbidities (other medical issues affected by weight). My LAP-BAND® clinic did all the paperwork based on my weightloss history and sleep apnea. I work for UnitedHealthcare, so can tell you that it all depends on what stipulations are written into the contract UHC has with your employer. For some employers, weight loss surgery is not a covered expense, for others, it is. So, anything you read on the postings might not apply to your employer's contract. Dig out your insurance policy or go on myUHC.com and read through the exclusions for your policy. Go through the motions and provide them a good weight loss history as well as all other medical history. You also have the right to appeal if turned down, but giving them all of the requested information up front sure helps to avoid delays.

deez9 · 10-25-2007, 09:20 AM

i have uhc, too. I got the call from the surgeon's office on last Monday 10/22/07 and I am scheduled for the psyc and computer test on 10/26/07. I asked uhc and was told that my doctor has all the info about my requirements and that all I needed to do was stay in contact with them. I have also gotten some documentation of other weightloss attempts eventhough they have not asked me for it yet. One of the surgeons is the doctor who has been treating me for the last year in my latest weightloss effort.

randiik · 10-31-2007, 01:49 PM

my insurance takes effect tomorrow nov 1. i am wondering how long i need to have the insurance before i apply for this. i do have a doctor appt with my primary on friday to see if he will help get me started in the process to get approved for LAP-BAND®. :)

deez9 · 10-31-2007, 02:02 PM

Call your insur co to get that answer. Some co will not cover procedures due to "pre-existing" conditions(depending on the insur and your benefits) until maybe having coverage for 6 months. Your insur co can only answer that for you.

Wheetsin · 10-31-2007, 02:08 PM

There are different plans offered by UHC and the requirements can vary by plan. (As an analogy, Dodge makes several different models of cars, just as UHC has several different models of coverage). You will find different requirements among different plans. Why not just call them back and ask what the requirements are? That's the only way to be sure.

deez9 · 10-31-2007, 02:19 PM

I took my 165 question computer test on 10/26/07. Boy, was I glad to get that over with. The frustrating part about this is that I have scheduled the next to the last thing (hopefully) that I have to do before the surgery. My psych eval. The earliest that I can get it is 11/30/07! My anxiety level increases everytime I think about it. I was tempted to go ahead and pay for it myself and have it done sooner so that I can get scheduled for the surgery sooner! But the psych eval costs $160. With insur it is only $50

destiny79 · 11-21-2007, 11:41 PM

:whoo:well since this thrad was first started I was approved I found out that my plan UHC CHOICE PLUS TEXAS the only requirement was a BMI 40 and over auto. approval. good luck everyone

more4u2love · 11-27-2007, 12:17 AM

I have been going round with my insurance(UHC)for over 2 months now.I call and they tell me they need one thing and I do it then when I call back to check on things they tell me they need something else.I have did everything I need to do and all I am waiting on is insurance approval.The bad thing is that I am slowly gaining back what I had lost because I am beginning to feel that the insurance is never going to give me an answer.Any words of encouragment are welcome and very appreciated!!!:help:

destiny79 · 11-27-2007, 01:45 PM

it only took me a week not sure but I know that the address on my approval letter is in Plano Texas only 20 miles from where I live not sure if that as anything to do with it
(sending approval vibes your way )

lol

deez9 · 11-27-2007, 02:37 PM

tomecia25, great news. Good luck! I am still waiting for approval. But, I have not lost hope. I know that it is part of a "process". Just like my decision was to have the surgery.

destynee990 · 12-04-2007, 02:03 PM

WoW I never thought about that! I had Kaiser for 18 years...I work for AT&T and I just switched to UHC ChoicePluse JUST to have the surgery! I hope that there is no time requirement of having the insurance b4 I can apply!! That would suck now since my doctor just submitted for the surgery yesterday!!

Ldysunfyre · 12-10-2007, 11:56 AM

I have UHC Choice Plus through my husband's work and I just found out about 3 minutes ago that they will not cover the procedure. I have a BMI of 45. My guess is that bariatric coverage is specifically excluded. Such is life, I suppose.

On to the old fashioned way again...

deez9 · 12-10-2007, 12:05 PM

ldysunfyre, did you just call them to ask if they covered the procedure, or has your surgeon submitted the request? I understand that it is a case by case procedure with them. I am still waiting. I had called last week and was told that a decision would be made within 30 days. Friday will be 30 days.