I am writing this to help those whom have United Health Care. Here are the following things to know and tips:

Before reading these tips, contact UHC for confirmation that Bariatric surgery is covered under your plan. Confirm the requirements. Confirm that your surgeon and his associated hospital is In-Network (if they are not, it will be like paying for the surgery without insurance). Make sure you have an understanding of what the insurance wants to see or have done.

1) You are eligible if you have a 40 BMI or Higher / Greater than 35 BMI with Co-Morbidity.

2) Once you find your surgeon, you will have to do 6 months worth of testing, dieting and education.

3) You will have to make 6 visits (once a month). This does not include your consultation.

4) One of your visits will be with a Psychological Evaluation. This will determine your surgeons view and the insurance company's view of your case. They take a look at your mental and emotional health. They ask about your family and your support systems. They may ask you how you feel about yourself. Stay away from the negative views you may have of your body. Understand that they have seen hundreds of people like you and may have some prejudice in regards to whether you will succeed or not. Remind them that you are a person, not a statistic and bring some human to your discussion.

5) Your surgeon may require you to keep an eating and exercise journal. I use MyFitnessPal and I have a FitBit.

6) You will be asked to do an EKG to see how strong your heart is.

7) You may be asked to do a sleep study. Depending on your surgeon, it can be a requirement. In my case, the insurance company denied it. They did not deem it as a necessity.

8) You will have to do an Ultrasound which is to see if you have any issues with your liver (fatty liver disease) or other organs.

9) The next thing is an endoscopy. This requires you to head to an outpatient clinic, be sedated and have a tube stuck down your throat. I learned that I had an hiatal hernia (where part of the stomach enters the diaphragm). This can cause you heart burn. Be aware of H. Pylori. This is a bacteria that can cause ulcers and heart burn as well. It takes a lot of antibiotics to cure. Be mindful that your throats will be sore and some sharp pains may occur as they most likely scrapped some samples from your digestive tract.

10) In between these visits, you will see an dietitian and nutritionist for further help. They will slowly walk you through changing your eating habits. Be honest with them. It is very important in the long run. Also try to keep your weight lost in small amounts. If you lose too much in a short period of time, the surgeon and insurance company will feel like you can lose the remaining weight alone.

11) Your last visit will consist of an overview. The surgeon will check your weight and may discuss further with you about your feelings towards the surgery. Hopefully you are approved by the surgeon. My surgeon was great during the process. I met with him more times than anyone else. He literally kept giving my information and sites to read to understand this tool.

12) They will then submit your information to the insurance company. Now it can take up to 2 - 6 weeks for approval. I was approved in one week.

My fellow UHC Members, I hope this assist you in your endeavors. 6 months will fly by so quickly you won't even realize it.

Remember education is the key to success.

I waited less than 2 weeks to get an answer. They had submitted my paperwork the same day. I believe I was approved on the 10th day of waiting. My surgery was scheduled the same day I got approval.

Okay thanks! Im new to all this just had my firdt appointment on aug 29 and have my second one on 09/25 im required to do the 6 month weigh ins

I am just starting my journey. I have my first dr's appt on October 16th and I cannot wait. I have been up and down with my weight for so long I really gave up. This is it I am so ready for this. My goal weight is 150lbs and I am going "ROCK CLIMBING"!

Thought I would add on to this post. I have UHC and I did not have to do an EKG or an ultrasound. I also didn't have to keep records of my food or exercise.
I did have to do 6 months worth of supervised dieting. I had to have a psych evaluation. I did have to do a endoscopy. My final appointment with my surgeon was to answer final questions. I was told approval/denial would be sent within 7-10 business days from UHC. It took them exactly 9 business days for an approval.
I did NOT have to lose a specific amount of weight beforehand and actually gained from my first appointment 6 months ago and still received an approval.
I'm located in Texas and could be different depending on which plan you have UHC. It's been a painless process though. Surgery is scheduled for June 12, 2017.

I also have UHC and I’m in Texas!! My paperwork was sent off this morning for prior authorization! I’m in Houston and having surgery with TLC surgeons!! I’m so glad I found your post! It says they can take 15 days to approve or deny!! I’m hoping I will hear something next week sometime!!

Oh my gosh this is good news I also have uhc my criteria is 6mo diet,psych evaluation and 40+ BMI my consult is today any other pointers would be great

Great info for a current 2018 UHC pre-op. After talking to my UHC Bariatric nurse I already had my appointment set with the Center for Excellence Dr as required. I have slightly different requirements but still the 6 month monitored diet, endoscopy and psychological testing. Everything else is held at the Bariatric Center. It’s really a great place that the doctors work together to have the dietitian, workshops ... whatever is needed right there! I’m hoping I do correctly for the monitored diet plan and progress enough to get approved but not enough to get denied!!

Edited February 6, 20188 yr by stacy71
Misspelled words

Great info for a current 2018 UHC pre-op. After talking to my UHC Bariatric nurse I already had my appointment set with the Center for Excellence Dr as required. I have slightly different requirements but still the 6 month monitored diet, endoscopy and psychological testing. Everything else is held at the Bariatric Center. It’s really a great place that the doctors work together to have the dietitian, workshops ... whatever is needed right there! I’m hoping I do correctly for the monitored diet plan and progress enough to get approved but not enough to get denied!!

Good luck !

Hi all.

Just want to give my experience with the UHC process. I made the decision to go this route in may of 2017. I made the call to UHC who set me up with Optum Health which is part of the bariatric sub division. I was simply required to complete 6 months of guided weight loss which I did through the Center of Excellence facility that I chose as everything was on site there. I completed this process in December. The facility tried to submit my info to optum only to find out my case had been closed. Finding this odd I called them, got scheduled to a call with a case worker on February 8th. Had the call and at that point the case was ready for review with optum for the "letter of medical necessity" However, I found out today that I have to do another call with a place called CBA which will take place on Feb. 15th. It is nice to see however that it seems like once it finally gets to UHC for approval they seem to have a pretty quick turnaround. Once that approval is given, surgery will be 2 weeks from that day!

That’s awesome! Seems like that’s the gist to UHC is the Center of Excellence doctors- and then their facility is all inclusive pretty much. I also spoke with the Optum Health nurse, which she didn’t really give me any information about insurance but... good too know from a patient side. It doesn’t seem like anyone on the forum, I can find, had UHC and problems.

I have UHC and also and contacted Optum per requirements (this year lol). I think besides the diet, psychological testing and meeting with a dietitian the rest are based on what the Center of Excellence doctor wants per individual.

Your list is extremely helpful for anyone looking for information ??

I'm glad I found this forum. I have UHC as well. I just scheduled my 1st appointment with the surgeon after have registered and done my 1st phone call with the Case Manager Nurse from UHC.

Anyone in the Tampa FL area?

Good Luck!!! I’m moving towards my third (out of 6) Dr required weight management appointment. All other requirements for surgery have been met at this point, except of course the pre surgery diet- but that is pending approval from UHC ?

Grerchen57 may I ask how old you are? If you are 60 or above there are quite a few of us active on Bariatric Pal. Look us up and let's chat. I'm 72 haven't completed my surgery yet, will Lord Willing and the Creek don't rise, this spring. Pretty upbeat except when this tired old Buckeye gets the blues. I first started seeking WLS August 2015 so I have quite a tale to tell myself. Don't be a stranger, none of us bite, be difficult for me cause I have dentures, good for chewing food but not very sharp. Technically I'm not a Baby Boomer, I missed it by just 5 days. I am an Occupation Baby, a select group, we were born August 6 to December 31 1945, we tend to hang with the Baby Boomers, shoot most of my oldest and dearest friends are Boomers. So pull up a chair and talk with all of us. I will be a RnY but sleevers are fine in my book, as are SIPS, mini bypasses and even lap-banders, RnY just will work better for me.

Adding my bit....I have UHC Choice Plus. The only requirement noted in my specific plan is a BMI of 35+ w/two comorbidities or 40+ without. I don't have to use the bariatric resources or undergo a supervised weight loss plan for any duration of time. From what I've noticed from other posts, it seems the nuances of your specific coverage is really driven by your employer. That said, I still have to complete a number of pre-approval things that my surgeon required; you know, the standard stuff that everyone else seems to be doing like psych eval, nutrition consult, and GI imaging.

Edited March 13, 20188 yr by destinystarr

With the ekg did you have to have your bra off?


Live life to the fullest

7 hours ago, susunorm said:

With the ekg did you have to have your bra off?


Live life to the fullest

I had to do mines with my bra off. They said the underwire would affect the test. My technician was a female.