Requirement of 40 BMI for over 5 years

I was doing my second to last appointment before I send out my paperwork to be approved by my insurance when someone slipped into conversation that United HealthCare requires that you have a BMI of over 40 for at least 5 years. I've been overweight my whole life but only over 40 BMI for 2 years. I've only seen this requirements on other people's sites but never on an actual UHC site, which doesn't mean that it's not true. I'm going to call my doctors office tomorrow to call UHC to see what the deal is.

Does anyone know anyone who got around this requirement? If they have this requirement, is there still a chance I could get the surgery? I only have ONE appointment left and we were hoping to have me get the surgery in August. I hope this wasn't all for nothing...

Do you have any comorbidities? (i.e. diabetes, sleep apnea, hypertension etc) Most companies allow for a BMI of 35 if you still are having trouble, bookmark me and let me know. I can link you up with a veteran who is a retired attorney and experienced with insurance company appeals. Let me know if I can help.

I wouldn't get too upset yet.  I have UHC and my BMI was 39.8 when I started this process and I was at my heaviest.  I was never told I had to be like that for 5 years, only that I could provide the info showing that I was overweight/obese for the previous 5 years.  Once I completed my 6 month supervised diet, we submitted my paperwork and UHC replied with an approval in less than 4 hours!  They were really quick about it.  I was able to have my surgery scheduled for 2 weeks after the approval (I was able to slide into a cancelation slot).  So I would suggest you complete the last appointment, then submit and see what happens.  From what I've read here and my own personal experience, UHC seems to be one of the easiest insurances to work with.  Or, if it will put your mind at ease, call UHC and talk to them about it.  Good luck to you! 

I had to provide 5 hrs of wt history. My 5 hrs only 1 was I over 40,the other hrs I was obese. I would not stress about it, especially if you have co morbidities.

Sorry, but I had the EXACT same issue with UHC.  I self paid.  I borrowed against my 401K and would do it again in a second.  I wish you the best of luck, but just wanted to give you a fair warning.

Try not to worry, If Dr Kauls office didn't think you would be approved, they would of told you right from the start.  They check out your insurance benifits from the get go.  As long as you have been over bmi of 35 and have co-morbidities, like Hypertension, diabetes, ect, most insurances with bariatric surgery as a benifit, will approve you.   Most importantly are the problems you have due to your weight.  Don't take this as gospel, but try not to worry until you thet the actual denial.  My BMI was 37, but I had 4 problems associated with my obesity and had my sleeve 6/9/2011 and now down about 24 lbs!!  Dr Kaul is the best!! 

Thanks everyone. I do not have comorbidities but I did have my sleep study last night, so there's a chance I have sleep apnea (my mother, maternal grandfather, and 2 uncles have it). I do have a BMI over 40 now. I'm going to call both UHC and my surgeon now. And I will submit everything to insurance anyway and hope for the best. Wish me luck...  :/

It will completely depend on the restrictions your company has put on your plan. I have UHC and my plan stated I had to be 40 or over or 35 with 2 comorbidities and that was it. No weight history, no 6-month diet, and no requirements on how long I had to be at that weight. You need to get a copy of your Summary Plan Description from your employer. It will detail what you have to do to get sugery!

I also have UHC and have just started the initial visit and mtg.- Have had several employees at work approved without any problems. The ins. repres. at the doctors office did mention the five years BMI of 40. - if comorbidities BMI of 35 ( I believe)