Panniculectomy Approval thru United HealthCare

Has anyone with United HealthCare(EPO) Insurance been approved for a panniculectomy for medical/health reasons recently???.....in appeal process right now....need tips

I am in the same boat with you....Dr. Anthone is appealing because the underwriter thinks I am doing it for "cosmetic" reasons....yea right!!!!  NOT!!!  I have United Healthcare PPO.  I had to write a personal letter, my doctor wrote a letter of recommendation and Anthone sent in another appeal letter.  I am still waiting.  Best of luck and keep me posted!

I worked for an AIDS practice for a lot of years. One of the things that AIDS does is give patients really sunken-in  faces.  UHC used to deny request for surgery to correct this because it was "cosmetic".  The most successful appeals we would send in were on the following grounds: 1.  Treatment of the disease is a covered benefit.  Therefore,  treatment of a condition that was directly caused by the disease should be covered as well. and 2.  If the policy would cover reconstructive surgery following mastectomy, but denies reconstructive surgery following treatment for obesity, this is discrimination! One of these, or both of these usually made it past utilization review at UHC after the first or second denial.   Good luck to you both. Wendy

thank you so much for the information....I am getting all my documentation  together and will probably have the NC Insurance Commission do an external review if I get denied again....take care

make sure there isn't a specific exclusion for panniculectomy.  My plan has that exclusion even though they pay for the bypass.   If they don't you might have a chance with medical documentation that it isn't cosmetic in nature.