United Healthcare in Missouri

Happy Loser · 02-25-2008, 06:19 PM

My sister lives in MO and has UHC Choice Plus and found out today that LB is not covered. This is what the Surgeons office told her. I was wondering if you could share what type of policy you have and see if there are any suggestions you could give us to help her get approved. She works for a small business and could likely get the plan switched if she just knew which one to go with. Any insight or help would be greatly appreciated.

sahmof3 · 02-25-2008, 08:39 PM

Quote:

Originally Posted by Happy Loser

My sister lives in MO and has UHC Choice Plus and found out today that LB is not covered. This is what the Surgeons office told her. I was wondering if you could share what type of policy you have and see if there are any suggestions you could give us to help her get approved. She works for a small business and could likely get the plan switched if she just knew which one to go with. Any insight or help would be greatly appreciated.

If you say she works for a small business, I would think the drs office is correct about it not being covered. I have seen that with a lot of small businesses. What she needs to ask if she is going switch is if WLS is covered under their plan. I would find the plan that you don't have to jump through as many hoops.

UHC does cover the LB, but you have to have WLS as a covered item. My BMI is over 40 with no co-morbidities and they are covering it. With a BMI between 35-39 with one co-morbidity would do it also found what I have seen.

Good Luck!

Happy Loser · 02-25-2008, 09:31 PM

SAHMOF3 Thanks for your reply. Her BMI is over 40 with co-mor. I was kind of afraid to hear that about the small business. Because with all the research I have done it seems like if it is small bus. group insurance it is excluded. This is the case with BCBS here in CA. In my case, my husband and I own a small bus. and are currently shopping for insurance. I am having my broker look at UHC specifically because I have read so many good things about it. But, I also told her that it needs to cover LAP-BAND^®. Hopefully I will hear back from her tomorrow with some good news. I don't understand why small businesses would not be allowed to have WLS coverage.

sahmof3 · 02-25-2008, 10:08 PM

I really think is comes down to the cost for the extra perk of WLS.

Good luck and I hope you get good news.

Missourimom · 02-25-2008, 11:57 PM

I am in Missouri and I have UHC Plus too. They DID NOT cover my surgery either. WLS is in the exclusion clause.

I was a self pay patient.

Chris61 · 03-04-2008, 02:06 PM

I have UHC and my employeer covers the band and all the fills. You might want to check your company policy and see what it says. When I started with the company 5 years ago it was not covered. Sometime in 06 they changed the policy. I happen to be looking up something else and saw that it was covered. To us about 6 months to get everything in place. Went to the Doctor in July and both myself and the wife were banded in Sept. If you would like e-mail me your address and I will send you a letter that we had used to get approved.

Chris