I keep reading posts on these boards about insurance, and the need to document the information I get from the insurance company. I just scared that they will deny me due to "pre-exisiting condition."

Thursday, 11-02-06, 6:30pm, I called the toll-free number on the back of my husband's UHC insurance card. After pushing a few buttons to get through to customer service, I talked with a man named LeLand. I asked him this question (straight from the paperwork supplied to me by Dr. Curry): "I am inquiring about my policy benefits on surgical weight loss. Is surgery for morbid obesity a covered benefit? In particular, I'm inquiring about lap-band surgery.”

LeLand: "Yes, it is. Lap-band surgery is a covered benefit."

Me: "May I please give you the code for this procedure and would you please check to see if this particular code is covered?" I gave him the code.

LeLand: (After sighing and acting like I was a pest) "Yes, that code is a covered benefit."

Me: "What information do you require before approving the surgery?"

LeLand: "You have to have a BMI greater than 35."

Me: "What else?"

LeLand: "Ma'am, just have your doctor's office call our care coordinator and they will work out the details. This procedure IS covered by your husband's insurance policy."

At that point I just thanked him and hung up because he acted like I was just a huge pest. What I SHOULD have done was stay on the phone and gotten all of the information from the paperwork Dr. Curry supplied to me.

Now I'm scared that if I call the insurance company back, I'll "tip them off" that I want to have this surgery done, and they won't put me on the policy. My husband just enrolled me this past week, and I won't be effective until 01-01-07.

Any suggestions? Should I call them again and get more specific? If I do, won't they think this is considered a pre-exisiting condition, and can't they deny me in January?

Hello everyone,

I have UHC too and was told that my BMI had to be at least 40 or 35 w/ health problems and 100 pounds over weight. Right now my BMI is 40 and I am one hundred pound over weght. I have been to the seminar and I just got my letter from my primary care physician today. So I have submitted everything to the doctor...I just have to "weight" and see what happens.

Hello, I know I am about 4 years late on this post but I am new to this and lapband. I am in the very early stages, as a matter of fact, I am going to the seminar this Tuesday. I have United HealthCare through my husband's job and he works for GE Healthcare, a extremely large company. I called them before I called to schedule my appointment and received the same response you did, the procedure is covered if I meet the criteria (the rep was very nice though!) I wanted to know if the insurance co required you to do a pre-op weight loss program and if so, how long, 3 or 6 months? What has been you experience with United Healthcare? Is there anything else you think I should know? I am so worried and excited at the same time. I am 255lb with a BMI of 41.

Thanks,

Excited! :thumbup:

Hi There!

I actually ended up changing insurance to Blue Cross PPO (this was through my employer). I think a lot of the insurance requirements depend on the surgeon as well. I didn't have to do the 6 month program because my surgeon saw my 14 years of weight watchers books and he said I did it.

I ended up switching from lap band to RNY. I had surgery 5 months ago and I have lost 80lbs. It has been the best experience and I am so glad I did this.

I just wanted to say best of luck to you and remember this will be a gift you give yourself. Keep the excitement, it will help you stay motivated to exercise and eat right.

Take Care!

:thumbup:

I'm also getting to this topic late. I have UHC through my husbands employer, but my plan is pretty limited (which is surprising - you'd think Georgia Pacific could afford a better plan for it's people!). I'm nervous about the insurance part, my husband is 100% supportive of my choice, but 100% concerned about the cost! I got a great impression from the Nurse Coordinator I talked with last week, I'm attending the seminar on Wednesday. Since my BMI is under 40 (it's 35.5) she said it may be a bit more challenging, but I've had high blood pressure for 12 years, and take medication for acid reflux. I've tried EVERYthing. WW, HCG diet (lost 60 lbs, gained back 55), low calorie, plus working out daily - we're taking the Insanity workout - and my weight will not budge. My MD's even tinkered with my thyroid med thinking it could be responsible, but I'm just stuck. REALLY praying UHC will be kind to me, I do not want to live my life this way anymore.