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will i get denied?

so im on month 3 of the 6 month diet required by United Health Care. i gained 1.5 pounds between my first and second month and i wanted to know if i would get denied down the road or if i would have to do more classes or what the protocol would be

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It really depends on your policy. What does your plan document say about requirements to be approved for surgery?

It does depend on your plan. But as long as you don't end up with a net gain at the end, you should be all right.

I wouldn't worry. The policy is that you adhere to the program, not that you lose consistently, or in fact lose at all.

I know in five years, I can't remember anyone denied for gaining on a weight loss program. We can't because the policy doesn't stipulate weight loss, only adherence to a program.

I hope this makes you feel better.

  • Author

i does make me feel better and my endo put me on victtoza and ive been losing about 2-3 pounds a week so i know ill show a loss at my next appointment

  • 3 weeks later...

Victoza hasn't helped me lose weight at all. I have UHC as well. I have gained and then lost and gained again. We'll see if I get denied I guess. I'm nervous too. I'm on the low end of the BMI and I believe only one comorbidity.

  • Author

well i went to my 3rd nut appointment it showed a 4 pound loss so yay. and @@snowflurry321 where are you having surgury

I'm in California. I will be at Memorial Hospital in Modesto if all goes well. The countdown continues. I just had my month 4 appointment so 2 to go.

Most insurance companies require that you have the same weight or lose weight during your monitored. As long as your at or below your original weight by the end of the 6 months you should be fine.

I had a significant gain and was approved with BCBS.

Nobody I know has been denied because of a gain. As long as the were strict about adhering to the monthly visits with a Dr. They were good to go.

Does anyone have united health care Oxford...liberty plan? I am going for my first appointment at the bariatric office and was wondering if my insurance plan covers this surgery

  • Author

well heres another hiccup int eh plan my insurance through my dads work is switching to bcbs anthem and i have to wait til monday to find out if they will even cover the damn thing im so stressed im so worried i have state insurance that will cover it but i dont know if it will be at 100% because they are my secondary and im just a ball of worry right now

If your primary does deny it your secondary will cover it all except your out of pocket. Hopefully your primary will cover it but if not you still have hope ????

  • Author

Yes I do have hope I am blessed to live in a state that requires Medicaid to cover it as a medical necessity

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