United Healthcare Insuarance

Anyone have the same insurance and had it approved, they changed things this year. I am so upset that now I have a few extra things on my list. I have everything done, have one more nutr. visit to go and was planning to submit on Jan 30th.. and now find out the insurance has more "requirements" I feel so defeated. I am starving on this liquid diet.. that I am on to show weight loss.. and I have done everything. The insurance covers the surgery 100% but getting them to approve it is scaring me! I am worried. I just want to start my life, and be done with this weight!! I am feeling so defeated.. any words of wisdom?

Any stories on dealing with insurance companies?? I just need to see a light at the end of this crazy tunnel, each time I think i see it, something else comes up!

I understand how frustrating it is, because I had to appeal a denial. But the important lesson is to learn to be patient and persevere when you hit speed bumps because there will be no shortage of speed bumps to get over post-op.  You will have a big learning curve to master with the reintroduction of foods and the need for regular, life long exercise. You'll have the inevitable stalls, and learn that your weight loss chart will look much more like a staircase with plateaus than a ski slope.  You really need to understand and accept that there will be lots of challenges ahead in the next year or two during your big weight loss and figure out constructive ways to cope and persevere. The weight loss process is a challenge and some days it is a part time job, but the rewards are priceless!

Take care and be kind to yourself!

I got my answer from UHC within 10 days.  Just jump through their hoops and they're cool.  They also covered all procedures, so I was delighted to get my DS without any arguements.

thank you! that gives me some hope

What everyone can learn from this is to not start a process in one year and try to fini**** in the next year.  Insurance companies change things every year.  I was very clear with my surgeon that I had insurance to cover my surgery that year, but did not know if I would be covered the following year.

They made sure my surgery was completed before the end of that year.  Just make sure that your surgeon does not put you off and that you meet this year's requirements and have the surgery before the insurance changes again.

 

See your nutritionist...I was on the liquid diet for 22 days and after day 3 I was not constantly hungry. Be sure you are taking in the hydration and protein you need and find out if you are able to have things like SF jello or popsicles. 

GOOD LUCK ON YOUR APPROVAL!

 

I am looking into United Health Care myself and am afraid of the changes you mentioned (I haven't purchased 2014 coverage yet)

I am afraid of all the hoops I will have to jump through to get approved. Can you please provide more info as to what the approval process entailed? I am wondering if this is the best plan for me.

I am located in NY. My BMI is over 35 but under 40 with 2 comorbidities.

 

Thanks!

thanks for the replies! this is taken right from our coverage book

1.8.26 Obesity Surgery

The Plan covers surgical treatment of obesity received on an inpatient basis by a Network Provider provided all of the following are true (unless otherwise determined by the Claims Administrator):

• You have a minimum Body Mass Index (BMI) of 40 or in some cases, a lower BMI accompanied by co-morbid conditions as determined by the Claims Administrator;
• You have documentation from a Physician of a diagnosis of morbid obesity for a minimum of five years;
• You are over the age of 21; and
• The surgery is performed at a Network Hospital by a Network surgeon, even if there are no Network Hospitals near you.

Benefits are available for obesity surgery services that meet the definition of an Eligible Expense and are not Experimental or Investigational or Unproven Services.

Centers of Excellence: Treatment is covered in full if you receive services from a Center of Excellence approved by the Claims Administrator. Surgical services must be performed by a Network surgeon. If you accept treatment at such a facility, GE may cover reasonable expenses for lodging, transportation and meals for the patient and one member of the patient's immediate family, provided the travel is approved in advance by the Claims Administrator. Prior approval is required.

Hope this helps

S~

I think I have the same booklet! This is word for word what mine says, too.

I was approved on the first try within a week. I just made sure to get everything together, and I also went to a bariatric surgeon that was approved by the insurance (which happened to be the surgeon I wanted anyway).

I still have my approval letter hanging on my bulletin board. I honestly think I may create a little scrapbook for my bariatric surgery, because even these little pieces of paper represent milestones and happy days.

thank you so much for your reply! I cant wait to watch your progress, hopefully i wont be to far behind you on the losers bench! I also agree about keeping those things as a constant reminder of where we are.. so we never come back! Best wishes!

S~