United Healthcare? - Page 3 - ThinnerTimes - Gastric Bypass Forum, Lap Band Forum, and Vertical Sleeve Gastrectomy Forum

pattida588@aol.com · 08-15-2008, 01:43 PM

Yes, my daughter was denied due to her insurance, UHC. The reason being is that the "plan" that was chosen for her group .. "excludes surgical and non-surgical" for weight loss/obesity. The Broker said that because the group is only 5 members, UHC won't include the gastric bypass; that the group has to have 1,000 members. I think that is B.S. -- but I don't know what to do now. We wrote the 1st appeal letter .. and there is something there that says we can do a SECOND LEVEL REVIEW .. but I'm thinking if the insurance says NO for that reason, they are not going to pay. We've tried to get $ numbers as to how much it would cost as a self-pay and they seem to be reluctant even to providing us that option. I guess I need a "lawyer" to help me with proceeding further.

Vikkator · 08-18-2008, 11:48 AM

I had called them prior to even starting this journey and they said it was covered. It really depends on your plan and what the employee's benefit is.

kaylx6 · 02-08-2009, 01:51 PM

Hello every1 I'm Kaylx6 I've been reading your blogs, threads, chats everyday and think that this is a wonderful idea. You guess really support one another this is just great to know that at the touch of a button one could have such open and honest people to talk to. I would like to tell you a little about myself and hopfully someone can help me out. I'm 37 5'2" with a bmi of 39.2. I've been diagnost with sleep apnea, stress fx,(hypertension, obesity, diabetes run in the fam). Can anyone tell me if and how hard it is to get approved for my bypass from United Health (formerly known as John Deere Select)?

Vikkator · 02-09-2009, 06:12 AM

Hi there and welcome. It was a fairly simple procedure for me with UHC, but it all depends on your employer's plan. I would call UHC and ask if it's covered and what the requirements are before embarking on this journey, if I were you. That way there will be no surprises.

kaylx6 · 02-09-2009, 06:38 AM

Thanks soo much, I'll keep you posted!

donajo715 · 02-09-2009, 08:44 AM

I had the same problem with my husband.. though it was different insurance companies. Many states have laws that state that if it is deemed medically necessary than the insurance companies should pay. You should look into it in your state.

kaylx6 · 02-13-2009, 09:50 AM

Hi guys guess who was approved yesterday? Yes I did, I thought I would faint, but instead thanked God! Thanks for your support.

Femme_Fatale · 02-13-2009, 10:04 AM

was anyone on SSDI when they were using united?