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United Healthcare choice plus 6 month diet requirements



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On 5/6/2020 at 8:57 PM, Machta said:

Thank you SO MUCH for suggesting that those of us who have UMR to contact the bariatric team there. I have learned so much in the past couple of days . . . the most important thing I have learned is that UMR / United HealthCare Choice Plus have done away with the 6-month requirement. I was told that giving them documentation from my doctor concerning the many different ways I've tried to lose weight over the last 15 years will be sufficient. This is HUGE (no pun intended). Once I choose a surgeon and center, UMR suggested having my PCP send over my entire chart to them for review. Apparently you can never have too much detail. Their policy is to give a decision within 30 days.

I feel so validated. I was really getting irritated at having to go through some 6-month kabuki theater exercise to satisfy a bureaucratic requirement when I've had so many failed attempts (Weight Watchers, Medifast/Optavia, mayo Clinic Online, and tons of exercise). This feels so much more reasonable. Thank you, UMR! And thank you, Chris NH!

Hi Matcha -

This is the insurance I have as well, I have my first meeting with my nurse case manager later this week. I was wondering if you have heard back about your approval?

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1 minute ago, NurseJaci13 said:

Hi Matcha -

This is the insurance I have as well, I have my first meeting with my nurse case manager later this week. I was wondering if you have heard back about your approval?

Not yet, but I expect to hear this week. I had to really push hard to get the surgeon's office to submit with my existing documentation. They wanted me to go through the 6 monthly visits that seem to be common. Keep on top of them!

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1 minute ago, Machta said:

Not yet, but I expect to hear this week. I had to really push hard to get the surgeon's office to submit with my existing documentation. They wanted me to go through the 6 monthly visits that seem to be common. Keep on top of them!

Okay, good to know. In our educational meeting, my surgeon seemed to think most of us with UHC get through in less than 3 months (it's the most common insurance in my state)...usually, around 8 weeks, which is fine (the office makes us do some nutritional coaching, meet with a psych, and join a support group, so I'm good with taking a bit of time to get through that while I wait).

Keep us posted!

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Update: I had my first appointment with the surgeon's assistant on April 30, at the height of the Covid stuff here in Colorado. I started to assemble records from my PCP and my endocrinologist, and checked back with UMR regularly. As of yesterday June 16, I have preapproval. Now I'm waiting to be scheduled. All in all, about 6 weeks from first appointment to preapproval. It was key to have all my documentation from my PCP (20+ years) and endocrinologist (10+ years). Good luck, all!

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