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United Healthcare - AT&T

help77584
on 10/24/10 5:50 pm - Pearland, TX
Anyone had any experience with UHC as an ATT employer?  I'd like to hear your stories.
abejita
on 10/24/10 6:29 pm - dallas, TX
I am not employed by ATT, but I do have UHC and I had no problem getting approved for vsg last year.

mary



I'm 5'4"      SW 220 / CW 130 / GW 115
Michele H.
on 10/24/10 6:36 pm - New Holstein, WI
I also have UHC but not as AT&T and they where really fast and appoved right away. I think alot of it has to do with what your employer wants. What kind of plan they have with UHC.  But UHC is one of the best to deal with. At least thats what my DR said before they sent mine in. I got my sleeve Sept. 16. took one week for UHC to app. Good luck
    
help77584
on 10/24/10 6:41 pm - Pearland, TX
Oh wow!  That's great news.  I hope mine goes smoothly.  I'm a lightweight BMI 35 but do suffer with one (maybe two) co-morbidities so there is definitely a medical necessity.
mrs_ellis2003
on 10/24/10 7:04 pm
i have UHC, it only took one week for them to approve!
help77584
on 10/24/10 7:06 pm - Pearland, TX
This is good news!  I'm anxious to get it done!
MzScarlett
on 10/24/10 7:11 pm, edited 10/24/10 7:15 pm - Seattle, WA
I did have them  and was not approved despite appealing several times and getting a lawyer involved, which is why I self-paid.

What are your co-morbidities? They are very specific about what they want, and you will have a tougher time with a lower BMI. How many documented years do you have your BMI recorded as over 35? If you don't have that documentation for at least five years, you may as well not apply because you will be denied.

AT&T has given 100% control to UHC to make decisions on the behalf of their employees. They do not intervene in any way, so there is no one to appeal to outside of UHC, not even your state insurance commissioner. The criteria stipulated in AT&T's policy is outlined in a very specific way, and if you don't meet 100% of the requirements you are out of luck.

If you DO meet them, you will be approved very easily. Good luck to you.
 
     
Height: 5'9"     SW:287  CW:168  GW:160
help77584
on 10/24/10 7:15 pm - Pearland, TX
High blood pressure and sleep apnea.
MzScarlett
on 10/24/10 7:19 pm - Seattle, WA
 How many years has your BMI been over 35 though? That is key. 

I have sleep apnea, highish cholesterol (216), serious foot issues caused by my weight, BMI over 40 when I applied, and was still denied.


 
     
Height: 5'9"     SW:287  CW:168  GW:160
help77584
on 10/24/10 7:23 pm - Pearland, TX
I should have the 5 years. Why were you denied?
MzScarlett
on 10/24/10 7:34 pm, edited 10/24/10 7:36 pm - Seattle, WA
 Did not have a BMI over 35 for five years. And get this, my BMI was was recorded on January 3, 2007 as 35.4.  My weight recorded in the middle of 2006 was one pound short of making my BMI 35, and they wouldn't count that year! Unfortunately, you can't make this stuff up.  Not that I'm bitter or anything. 

I would not be covered until the year 2012, so I decided I didn't want to wait. :)
 
     
Height: 5'9"     SW:287  CW:168  GW:160
MTGermann
on 10/24/10 8:16 pm - Copake, NY
I have UHC and was denied at first then later approved.
mallrat
on 10/24/10 8:25 pm - St Peters, MO
I am an AT&T employee with UHC and they have been great.  They have covered 2 lapband surgeries and my revision to VSG.  In all they have paid for 4 surgeries, because I could not have my second band  put in at the same the first  one was removed due to inflammation in my stomach.  Had problems with both bands due to slippage.  I had my revision from  lapband to VSG on 8/18 and they approved very quickly.  They usually approve within a week to 10 days.  As long as you meet the qualifiications, which are 40 BMI with no co-morbidities or 35 with at least 2 co-morbidities they should apprpve.  I did not have to provide the 5 year documentation.   I see you are in Texas, so you should be covered by the same UHC plan as what I have.  I'm in MO, but I think all of the MOKA and TX areas should have the same plan.   I work with quite a few people who have had WLS and have never heard of anyone having a problem being approved.   Let me know if I can answer any more questions.  
MzScarlett
on 10/24/10 8:34 pm - Seattle, WA
 Mallrat, how come you didn't have to provide 5 years of weight documentation? That is a requirement (including everything else you mentioned in regards to the BMI and comorbids) I'm so curious to know how you got around that. What year did you have your first surgery?

I'm still trying to get my surgery covered, and would be eager to site someone who was approved without the 5 year weight history provided. 

UHC is VERY fast about approving or denying, I will give them that! :)
 
     
Height: 5'9"     SW:287  CW:168  GW:160
mallrat
on 10/24/10 8:41 pm - St Peters, MO
I had my first lapband done in Sept 06 and I think my BMI was aroound 46 at the time.  UHC never asked me for any type of documentation of being overweight for 5 yrs.  Not sure why.  All I had to get was a letter from my primary doctor referring me for the surgery.   Maybe they are wanting yours because you are so close to the 35 BMI point.   Of all the people that I worik with that have had some type of WLS, I dont know of anyone who has had to provide that.  
MzScarlett
on 10/24/10 8:49 pm - Seattle, WA
 Thanks, Mallrat. That makes me wonder if the AT&T plans vary by state or if the policy has changed its requirements since you first applied because I can assure you for me it was a non-negotiable requirement.

My BMI was over 40 when I first applied for approval back in 2009, but that was the first year my BMI reached 40.

I do know I'm not the only one, though, who has had this issue. The lawyer I worked with has unfortunately had to challenge the AT&T/UHC plan several times on the behalf of people going through the exact same thing as myself.

It really ****** me off, the five year weight history requirement. What should matter is my weight now, not what it was at any other point in time!
 
     
Height: 5'9"     SW:287  CW:168  GW:160
Spiritus
on 10/24/10 8:59 pm - Hawthorne, CA
Boy do I miss my years with A T & T....

                                                                                                                                                                     
           

HappyHunny
on 10/24/10 10:01 pm
I too an UHC and altho ppl I know had no trouble they wouldnt approve me because of no health issues and my BMI wasnt over 40, which was ok I totally understood, but most ppl that are over 40 or have health issues from what ive seen have no trouble at all....good luck!
abejita
on 10/24/10 10:06 pm - dallas, TX
When I called UHC, they said that I had to have 5 yrs of over 35bmi (which I had) and a six month supervised diet...but they approved me before I could even send all the paper work in.

mary



I'm 5'4"      SW 220 / CW 130 / GW 115
skjlloyd
on 10/25/10 8:57 am, edited 10/25/10 8:58 am - Bowie, MD
I've talked with UHC several times over the past few months just to make sure I get the same response. I was told my primary care doctor has to submit a letter as to why I should have the surgery (I have diabetes 3 yrs and high blood pressure 18 yrs) and they would send approval letter out. I did all the other tests etc for my bariatric surgeon it was not something UHC required. All they want is the letter from my primary care doctor.
SW 248 CW 170 GW 150