Question:
How long do I wait to seek approval?

I have just recently (yesterday) bought a policy through united healthcare. From what I can tell there are no exclusions about wls. I have never before carried insurance. My question is how long should I carry the policy before I request that they pay for wls? Is there some rule you follow? I know there guidelines from reading this board, and I can meet them, but would they laugh at me if I submitted the claim in say two months? Thank you all, this board is great.    — Paula W. (posted on January 15, 2004)

January 14, 2004
Typically you can get an approval for surgery as soon as you are effective, but since tyou did not have previous insurance you may have a pre existing condition clause in your policy. It just means you have to wait a certain amount of time before they will pay for some things. You can either look in your book or call your insurance to see if you have a pre-existing clause.... Good Luck
   — Mandybub

January 15, 2004
The previous poster is correct. Check to see if you have a pre-existing clause in your policy. I'm may be shooting myself in the foot by saying this, but I paid claims for UHC for 5 years. Trust me, NO ONE looks at the effective date of a policy in comparison to any procedure. That is not even thought of. The pre-x clause should be your biggest worry. Because there are so many factors leading to you wanting to have WLS, you will have to be treatment free of all of them for one year in order to get them to pay for the surgery. Some policies are 6 months but they are few and far between. Rebecca 10/03/01 265/140
   — RebeccaP

January 15, 2004
paula, check the fine print carefully!! i had united health care and they had a written clause that NOTHING TO DO WITH WEIGHT REDUCTION INCLUDING MEDICALLY NECESSARY was covered. I say get it in writing if you call the insurance people and they tell you yes. i also had gone to a podiatrist d/t painful feet he ordered orthotics for my shoes $400! the ins co said 3 times it was covered. the orthotics came in and they said they weren't covered and I had to pay. my husband had Cataract surgery one in dec, one in jan. they paid for everything except for the surgeon on the first one, and the anesthesia on the second, he had the same procedure,doctor,anesthesia,nothing different except for the dates! so be very careful. then there are people here that had the same ins and were covered. every plan is different. best of luck, cathy
   — CATHYSDAN

January 16, 2004
I had my insurance one month before the doc applied for approval, and it was approved really quickly. But that is true about the need for continuing insurance sometimes, they can consider it a pre-existing condition or something. I had continuous insurance, don't know if that made the difference or not.
   — Kimberley E.

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