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United Healthcare

mylastchance21

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mylastchance21    82

mylastchance21
Posted

Hi everyone! I'm wondering if anyone has any experience with you UHC group insurance. Bariatric surgery is covered under my employee's plan. However I called to get specific information about the diet history and no one can give me anything specific. My question is does the 6 months of supervised dieting have to be a specified number of days apart or just in separate months. I have my 5th appt on the 27th which will be like 27 days since my last appt and if possible I want to schedule my last appt for October as soon as earliest as possible so I can get everything submitted. I have called UHC, I have chatted with them and they keep saying there is nothing in the policy that specifies how many days apart the visits have to be. They just have to be 6 monthly visits

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katie09/21/2016    137

katie09/21/2016
Posted

I have the same insurance & I just had to weigh in once a month (didn't matter what day of the month) but had to lose weight at each appointment for 6 months.

I had my surgery approved, but it's "shared responsibility" - so UHC will cover 80% of the surgery. On the day of my surgery (21st September) I have to pay the remainder which is going to be around $2600. This is for the gastric sleeve.

No one told me about the payment even after my surgery was approved - I had to make 100 phone calls to find out for sure and then 100 more to get the amount I need to pay the day of surgery.

Goodluck with everything :)

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mylastchance21    82

mylastchance21
Posted (edited)

Well I haven't met my out of pocket max. So at the most I will have to pay $2400. I have only paid $100 towards the $2500 so far. I don't know if I will have to put before or after surgery I guess I will find out soon. My policy doesn't specify that I have to lose any weight but if lose I have been and plan to be less then my initial weigh in. Good luck to you as well! I'm hoping a can get a surgery date before the end of the year. I'm doing the sleeve also

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Edited by mylastchance21

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MHBTS    14

MHBTS
Posted

I have UHC and just got my date. I just had to go to the doctors once a month for 6 months to weigh in. Not specific on # of days in between. Good luck.

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cperetz3    4

cperetz3
Posted

I had uhc and I had to have 6 apps in different months not any specific days apart. App 5 was on the 29th and the final on the 6th of the next month. Got approved 2 weeks later

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chycky    671

chycky
Posted

I would say in the insurance world when they say 6 months they mean 180 days exactly.

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ToriTori    1

ToriTori
Posted

when weighing in on these 6 months, did everyone have to show weight loss? I have gone up in weight actually being on a diet.

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katie09/21/2016    137

katie09/21/2016
Posted

when weighing in on these 6 months, did everyone have to show weight loss? I have gone up in weight actually being on a diet.

I had to show weightloss every month I weighed in, even if it was only one pound.

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Shauny85    31

Shauny85
Posted

Hi everyone! I'm wondering if anyone has any experience with you UHC group insurance. Bariatric surgery is covered under my employee's plan. However I called to get specific information about the diet history and no one can give me anything specific. My question is does the 6 months of supervised dieting have to be a specified number of days apart or just in separate months. I have my 5th appt on the 27th which will be like 27 days since my last appt and if possible I want to schedule my last appt for October as soon as earliest as possible so I can get everything submitted. I have called UHC, I have chatted with them and they keep saying there is nothing in the policy that specifies how many days apart the visits have to be. They just have to be 6 monthly visits

Sent from my iPhone using the BariatricPal App

I am not sure I have the same insurance company. I live n Washington state and they require 2 appts a month. It doesn't matter how spread out they are as long as its 2 so I had to do a total of 12 appts so 2 every month for 6 mos.

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mylastchance21    82

mylastchance21
Posted

Just a quick update- for whatever reason my doctors office submitted my info for approval to the insurance company before I completed my 6 visits. I had only completed 4 and the insurance specialist submitted it because she said she thought I was through. Nonetheless it was somehow approved without me completing those last two visits! So my surgery is scheduled for 11/3!!!!! Super excited and nervous as well

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Go To Topic Listing PRE-Operation Weight Loss Surgery Q&A

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    • Aunty Mamo

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      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
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    • BeanitoDiego

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      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
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