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You can probably Google your health plan's medical policy to find out: "nameofhealthplan state medical policy bariatric surgery"

I am not aware of any health plans that don't require some kind of documentation of how long you've been overweight, and what else you've tried and not been successful. They all just word it differently.

Good luck!

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I have UHC, and they dropped that requirement (via my employer) 2 years ago. You do have to have "some" proof of "some" structured weightloss via a PCP or weight watchers,etc. That used to be 6 months, but now there is no actual specific number of months. You must have a BMI of 40 or if BMI of 35-39 you must also have comorbities (ie sleep apnea or diabetes, etc) You do have to use a Bariatric COE as well. The bariatric hosp will require a EGD and psych eval.

Oh..and you must be over 18 years old

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I think it depends on what our company has contracted with UHC. One person below states you no longer need the 6months of medical supervised weightloss program, but I just passed in all my paperwork for preapproval with UHC two weeks ago and I had to provide the following:

  • 6 months documented medical weight loss program
  • 2 years weight record showing obesity
  • Pullmonary Function Test
  • EKG
  • Psych Eval
  • Eval from nutritionist
  • Letter of approval and recommendation from PCP
  • Surgeon selected must be with COE unless the closest one is over 150 miles away

there are alot of hoops to jump thru with UHC before you can submit for approval. Good luck.

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Marley, I have UH and my list looks similar to Japeters. I don't need the PCP approval probably because I don't need referrals on my plan and I don't have to go to the pulmonologist because I don't smoke or have any known respiratory issues.

If you've been getting an annual for the last 5 years they weigh you every time so there's that history! Easy Peesy! Make sure you have that right - weight history vs. weight loss attempts. I think I'm going to have to make an appointment and sit there while my pcp write the dates of my weight loss attempts. I hate to keep calling but I'm not letting them hold me back.

Also, they had me sign up with this clinical nurse to follow my care! blah blah blah.Its required.

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I actually had an appointment today with the dr. I also met with insurance lady. She is 99 percent certain all I

Need to turn in is 5 year weight history from my pcp. ( which I turned in). She wanted to schedule surgery today. I wasn't ready. Still praying about it. It's a huge step!!!!

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Don't give up!!! Get all your info together. All I had to do was call my dr. The nurse did it for me. They were very kind. Good luck:)

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