I currently have UHC Community Plan of Ohio and I am having trouble figuring out what the requirements are. I have called the insurance company several times myself and all I can be told is medically necessary and that I have to do the 6 month diet. My PCP and Surgeons office called and thats all they were told, medically necessary, and a 6month diet.

I have been going to a weight loss program since July and I have completed all of the requirements on their end and the surgeons end. I just have to meet a few more times with the dietitian and nut and pcp to complete my 6 months. My last weigh in is in December. After that, they will submit an approval for the surgeon.

BUT is it really going to be that easy? I feel like I am going to get a denial.

I have a BMI of 45. I have no real comorbidities. I have gerd, pcos, depression, plantar fascitis, and hip problems. I just feel like because this is a medicaid plan, it is not going to be covered. I hope that I have not been going through this whole process since July for nothing. I finally emailed these questions this morning to my insurance company hoping to finally get an answer in writing.

Any information that anyone has would be great.

Edited October 25, 201411 yr by RachaelThomas

That seems to be the format for everyone that was approved. A supervised diet if required by your insurance, preoperative tests, physch eval, maybe a support group and insurance that covers bariatric surgery. The magic receipe =). Best of luck to you!

Call UHC directly and ask for the BRS Department. They will answer any questions that you have.