UNITED HEALTHCARE PPO

[taweedeegirl 68]

does anyone know the policy and procedure to have approval to receive the sleeve surgery through them ?

[GreenEyes604 753]

What state are you in? I have UHC in Maryland and was approved with no problem. Depending on your location and employer, the plans differ.

[Sleeve_Sistah85 193]

You have to call your insurance. I have United Healthcare Choice Plus through my employer in NY.

I called them up and they required:

-BMI 40 or 35 with co-morbidity

-6 month physician supervised diet

-Psychiatric consult

I was also linked up with a Bariatric nurse who referred me to a Bariatric center of excellence.

Good luck!

[cmorales0808 2]

Sooo happy , I just found out that I've been approved. .it was pretty quick..6 days. .I have UHC.. waiting for my surgery date!

[taweedeegirl 68]

do you have to have the surgery at a excellent center if it's through your employer?

[wannaBthinsoon 1,634]

I will have UHC PPO as of Jan 1, so I started the 6 month Dr supervised diet 6 months ago. Today was my last weigh in. I gained. Dang it! I scheduled another appt for the end of the month, and I will be eating chicken and green Beans twice a day to lose what I gained, so I can show a loss. Anyone know if UHC would deny me if I failed to lose in those 6 months? I'm in Kansas.

[Sleeve_Sistah85 193]

I will have UHC PPO as of Jan 1, so I started the 6 month Dr supervised diet 6 months ago. Today was my last weigh in. I gained. Dang it! I scheduled another appt for the end of the month, and I will be eating chicken and green Beans twice a day to lose what I gained, so I can show a loss. Anyone know if UHC would deny me if I failed to lose in those 6 months? I'm in Kansas.

I gained 1lb at my last weigh-in and asked that very question. They physician assistant said they would not deny for that reason.

[cassaundra 0]

I have UHC Choice Plus in Texas and they said that my plan excludes weight loss surgery. I am just wondering if there is anyway I can fight them to cover WLS at all. I was told that it was because my husbands company must have chosen to exclude WLS. Texas is a state that opted out of requiring insurance companies to cover WLS.

[taweedeegirl 68]

You have to call your insurance. I have United Healthcare Choice Plus through my employer in NY.

I called them up and they required:

-BMI 40 or 35 with co-morbidity

-6 month physician supervised diet

-Psychiatric consult

I was also linked up with a Bariatric nurse who referred me to a Bariatric center of excellence.

Good luck!

what status are you currently in with them ?

[taweedeegirl 68]

What state are you in? I have UHC in Maryland and was approved with no problem. Depending on your location and employer, the plans differ.

what was your starting and ending BMI?

[taweedeegirl 68]

Sooo happy , I just found out that I've been approved. .it was pretty quick..6 days. .I have UHC.. waiting for my surgery date!

did u have your surgery already?!

[dmjost@gmail.com 0]

UHG denied me. I'm in appeal

[AquariusDiva 15]

I had UHC last year and went through the whole process but was denied bc they required a 5 year med history of obesity. I was missing a year and one year was deemed too low. Dr appealed and got it overturned (probably bc they had 8 year history with me being overweight. But it came through at the end of the year and my dr was on vacay. So did another submission to my new insurance in January Cigna- they denied it bc the surgeon, Nut and psych were over a year old 12/13. Appealed with new visit to the 3 of them and they overturned it. So I'm now scheduled for 3/16.

I did gain a few lbs during the 6 mom supervised program ... But that wasn't why they denied it ...

[wannaBthinsoon 1,634]

UHC no longer requires your weight history...5 years or otherwise. I know they denied a few people I know last year due to that requirement, but this year it was dropped. I assume all UHC,

[AquariusDiva 15]

Argh - that would figure that UHC dropped it this year!