I called my insurance today (United Healthcare) and Lap Band is covered at 90% which is awesome but then I was told I have no Bariatric Resource coverage, which I guess is just a service some employers pay extra for, it covers having a team find you a doctor and I guess they work with you and help you understand the procedure, aftercare, etc. I'm guessing this is no big deal because I have already found a surgeon close to me (1 1/2 hrs drive away) and I'm sure he will give me the info on the surgery, etc right? And this surgeon is in my network so there shouldn't be any problems.

The question I do have is; when I asked what the guidelines were for the lap band all the lady could give me was the "generic" version off something she was reading, she stated you must be obese and have health problems relating to the obesity, she did not give me any BMI numbers or anything???? When I visit my PCP and he sends me to the surgeon will they be able to get all the guidelines? I really wanted something in writing to take to my Dr. so he could see the guidelines.

Well I guess I'll just go and if I get denied I'll appeal it.:laugh:

Ronni, can you call now and find out if there a weightloss surgery rider on the insurance? I have always been able to call to see if specific things are covered. They have always been more than happy to tell me. My employer also has a copy of the policy on our HR website.

I also have UHC but have had little to no luck talking to someone about this procedure in fact i was told by a rep that the bariatric resource services actually meant that they do not cover any weightloss support at all. so im guessing that i just talked to someone who either didnt care or was ignorant about what they actually cover. so my question is for those of you who have UHC and have contacted them regarding this to determine coverage..who should i call..just the number on the card?? and what specifically do i need to ask. it is becoming my experience that they will tell you you dont have coverage for things just so they dont have to pay for it ...can anyone help me out with this..i have been tryingto find a way to self pay for the surgery but if ins actually covers it that would be superfantastic as i have been worried about after the surgery..if i self pay..if there are complications if my ins will cover or if another dr will even touch me because of the procedure...if anyone has any advice and can help guide me i would really appreciate it. also if any of you who have uhc that live in co have suggestions for dr's i should check into for this procedure i would reallllllly appreciate it as i am new to this journey! thanks!:thumbup:

Have them send you an actual COPY of your policy with all appropriate riders... This will tell you if WLS is excluded. The "No bariatric resource coverage" sounds like a big red flag that WLS is NOT covered.

...so my question is for those of you who have UHC and have contacted them regarding this to determine coverage..who should i call..just the number on the card?? and what specifically do i need to ask.

If you have a surgeon I'd ask them about contacting your insurance company. My surgeons office contacted them for me I haven't had to talk to UHC at all yet. They know all of the right stuff to say and ask. I also have a coordinator that has been putting my packet together she let's me know what she needs I contact the medical dr's and they send it directly to her. I hope it doesn't bite me in the backside later.

Our company is suppose to have dedicated representatives at UHC that are suppose to be for us only and a special number but who knows they are all probably in one big room and answer whatever line passes to their desk.

Edited February 2, 200917 yr by JayTee562
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