United Healthcare Choice Plus requirements

 I'm preparing for VSG and I've been trying to work with my insurance, UHC choice plus. I have all of the info on the surgery and it is covered. Even at 100% since I've met my deductible and out of pocket for the year. I can't get anyone to tell me about the requirements for the surgery, though. The person whom I spoke to, said he couldn't find any requirements and that I would have to have my Dr. submit everything first, then they would let me know what's required. I started doing the 6 month supervised diet and will have it completed on Monday, but my Dr. only weighed me monthly and never instructed me to do a diet or a weight loss program. I did WW for a year in '10 and failed at that, along with every other diet I've ever tried. I'm afraid now, that the weigh ins monthly won't be enough. I'm 5'3, 233 lbs and a BMI of 41.27. I've read on other posts (from 2009) that UHC choice plus did NOT require the 6 month diet, but UHC did. Does anyone know? I've done the seminar and have my first appt w/ my surgeon in a month.

My company changed to UHC in Jan, 2012. When I called there was no required anything & I had my surgery Feb.27th, 2012. The preexisting clause was waived for us if we enrolled Jan 2012. Choice Plus for me My BMI was 47. with several comorbids. I was approved in less than a week! My doc office did all the work & I just showed up for surgery after cardiac clearance & bloodwork!! Good luck

 I'm hoping that is my case, too. I would hate to have to start the 6 month diet all over again, if the weights aren't enough. :(

I have started the UHC insurance process as well, I got a letter from US Bariatrics with the information that the insurance company needed, which by the way, did NOT include the 6 month dieting. My dr just sent the medical necessity letter and I got an e-mail back from the office that now they just need the "5 years of medical" ! I am not sure what that is for if they have my doctor saying that it is medically necessary. It is becoming more frustrating each time I hear something back.  I am in Florida and not sure if it is a state thing or just a policfy rider thing.
Good luck with your surgery (which i  hope happens soon for you. I am considering going to Mexicali to see Dr Aceves as I have a friend who did that last year and is at her goal weight all ready. I think she had the surgery (VSG) a little over a year ago.  I would love to keep in touch with you and find out how things are going.
thanks for sharing your information!
Sue Smith ([email protected]) I will appreciate any help that anyone can give.

 I will keep in touch and let you know how everything goes, as it unfolds :)

that would be awesome! I wish you the best. I will let you know too if I find out anything of any value.

i have uhc as well.. you can go online at myuhc.com, then once you register, you can access all the specifics and requirements of your plan.. the "pre-diet" shows as a requirement, but i was never made to do it.. the only thing i had to have was the required bmi, along with at least one comorbity.. good luck!

What your plan requires depends as much on what your employer is willing to pay for as what UHC wants. You need to look at the plan YOUR employer is paying for by looking at what is in the booklet that was sent to you by your employer for the year.

We kept getting the "he needs a 6 month physician supervised diet" by the surgeon's office who was going by what UHC said...our PLAN did not say that but DID require a five year history of MO. We took our booklet down to the surgeon's office and made them copy the pages involved to prove it.

Liz

 I've been a registered member on myuhc.com for a long time. There's nothing that states anything other than a BMI over 40 or BMI 35-39 with at least two comorbidities. As for my employer, there is no booklet. I even requested several months ago for another medical reason, and all I got was a thin stack of papers explaining my benefits, but nothing too detailed. I'm going to call the lady over insurance through my company in the morning and see if I can get an answer that way. It's so frustrating trying to get an answer to something so simple. 

My problem has been trying to find a physician in the network. Of course they do not have category for Bariatric surgeons. You have to just look under surgeons and try to find one that you have seen on the forums or recognize the name. That was the only way I found out that Dr Merama was in the network. But he is the only one that I found on the network in m y area.
Good luck!