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i was wanting to know if there is anyone out there that has been denied through united healthcare but their appeals were successfull? back in november when calling to find out my benifits 3 different times i talked to different people ( with united healthcare), they said lap band was covered as long as i had a predetermination letter. when i went to see the doctor, he said i was a perfect candidate for the lap band. when i talked to the insurance coordinator for the doctor, she said that since they said that and united healthcare was so good about approving it, she said i have 100% chance of getting it. we just had to wait for the final approval letter before we could start the process. well 3 week later i recieved a letter stating that i was denied because it was an exclusion in our policy. i was really upset. of course we appealed it and now just waiting. is there anyone out there has delt with the same thing? how did it work out? i guess im just trying to see if i should get my hopes up or what. it is like a emotional rollercoaster everyday wondering, am i going to get my life back, or am i going to miserable for the rest of my life. i cannot afford this surgery without insurance help.

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I don't have UHC, but I wanted to give you some encouragement...

APPEALS work, just look at all the people on here who have appealed and won!

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This might be dificult, but not impossible. This is not a UHC issue. Your employor who the the policy is through has excluded lap-band as a way to save money for the company. They probably got a better deal by excluding certain things from their coverage.

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Wow-that sucks. I have United HealthCare, but They approved my request. Although, I had to pre-pay for my surgery, and am now waiting for re-imbursement, but they did say that the procedure would be covered. So, now I am just waiting. They told me when I first called that if they did approve it, it would be covered at 90%, so I am really hoping that is the case. I am also a little worried about them paying for the anesthesia, and the surgery center along with the actual doctor. If they don't, I am going to be very upset, and appealing right along with you! Don't give up though--maybe your doctor's office could help you with your appeal--they know the right terminology to use. Good luck with everything!

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I have UHC and never had a problem with them covering my surgery the first time it was sent to them for approval..My dr did say that for an approval without a medical problem your BMI would have to be 40 or above..The only thing that I had to pay out of pocket was my regular copay..But I do believe that the company that you work for can actually exclude certain things from the policy when they sign up for it..I say fight it and appeal it till you cant any longer!!

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      · 0 replies
      1. This update has no replies.
    • Doughgurl

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      · 2 replies
      1. Selina333

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
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