Has anybody gotten approval with United Healthcare that did NOT have the bariatric rider to their policy?

Has anybody gotten approval with United Healthcare that did NOT have the bariatric rider to their policy?

Do you have a group or individual policy?

Group policy....

Do you have a group or individual policy?

I had my first bariatric procedure in 2006 under UHC without a rider. It was in the primary coverage indicated by the policy. My surgery (AGB) was not the only covered procedure at the time, but I can't tell you if VSG was.

Were you approved the first go round or did you have to appeal? I dont think VSG was an approved surgery for UHC back then but I know it is now.

Generally speaking, if there is no rider, there will not be coverage. It works a lot like flood insurance on a house. An adjuster can come in, acknowledge there is damage, that the house is flooded, that it is inhabitable and needs to be fixed.....and shake their heads at the shame of it because if that kind of coverage has not been purchased, they are NOT going to pay to fix it. Period.

They can look at all the health information, see where the patient would benefit from the surgery, see the obesity, the health problems, etc....but if the coverage isn't paid for....they are not going to pay for the surgery. Anecdotal stories pop up once in a blue moon, but 99.99% of the time, no bariaric rider - no coverage. Period.