Hi! I'm new to the site and was wondering if anyone has dealt with United Healthcare (Caterpillar)? I've been to see the surgeon and after talking with the adminstration was told that in order for United Healthcare to pay, I would have to have five years of documentation along with a BMI of 40. So, I'm guessing, I'm already going to be denied, since my BMI has never been 40. Has anyone ever been denied because their BMI was 39 and not 40? Thank you!:confused2:

:thumbdown:Just got a call from the doctor and my policy with United does not carry any form of weight loss just as I suspected. Off to Weight Watchers I go!

Hi all, I know this thread hasn't been active in a while but I'm pretty new (ok really new signed up yesterday lol) and I have UHC. I just want to know if anyone elses benefits said the same thing and then something else came up that they need (6-month diet or the 5 year weight history). This is what my insurance broker sent to my HR manager, it's straight from the manual:

13. Obesity Surgery

Surgical treatment for morbid obesity when provided under the direction of a Physician when medically necessary as determined by us.

Surgical treatment of obesity when provided by or under the direction of a Physician when either of the following criteria is met:

The Covered Person must have a Body Mass Index (BMI) of greater than 40. The Covered Person must have a Body Mass Index (BMI) of greater than 35 with complicating co-morbidities (such as sleep apnea or diabetes) directly related to, or exacerbated by, obesity.

I just want to be prepared so that I can get anything I need together asap. I was told that after I had my nutritionist evaluation and surgical consultant that's when the insurance coordinator would submit everything for approval.

I have UHC and had no problem with approval. I had my diet history for the past 10-15 years of ups and downs in weight loss. My BMI was over 40 and I had no co-condiitons. I was approved first time out. I needed to do nothing else for the insurance company . However, I had to do lots for the doctor (ie sleep study, psychologist etc.) I first saw my doctor on September 14 2008 and had the surgery on November 6th 2008.

I did have to have 5 years of history and 6 months in the last year (didn't have to be in a row) someone else on the same plan as me same Dr. has to have his in a row. Seems they change/apply the rules randomly.

I would love a sample of the letter u used...

ONEPICKYONE@GMAIL.COM