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

Vikkator · 05-27-2008, 09:55 AM

I was wondering if anyone here has been denied by UHC. I've seen stories from people who were approved, but none that have been denied. I'm concerned that they might deny me because I keep gaining weight. I know that I'm probably eating too much, but I quit smoking last year and that has always made me want to eat more, and as a result, gain weight. I'm getting over the ravenous cravings I had at first and the gain is tapering off, but it still creeps up on me, even though I'm watching it and working out. I don't binge and never have and I haven't been morbidly obese for very long (only about 8 months). I had been in the past but lost the weight (I started smoking again--can't and don't want to do that again). The surgeon's office also told me that if I lost too much weight before surgery, I wouldn't qualify. I want to lose NOW, but it'll probably be at least 4 months before I can get the surgery due to surgeon's backlog.

Native2u · 05-27-2008, 10:03 AM

Hey~

How much have you done, as far as the diet program/psych/nut eval.? If you are almost done or even half way....I personally say, wait and see what happens.

I have Aetna as my insurance and they did deny me...and I'm appealing it as we speak.

This one is your call. If you want to loose weight now and you have the will power to do it...do it. Just now that you might not get approved, if you loose too much weight.

Momof3 · 05-27-2008, 11:44 AM

I was denied by UHC...but I had a policy exclusion

CiCi · 05-27-2008, 12:18 PM

I have UHC and the eligibility for me 3.5 yrs ago wasn't bad, but I believe it depends on your employer as well. From what I know, they set a guide with UHC as to how strict/lenient UHC should be. I'm sure it has to do with cost.

I had a BMI of 40 with no real co-morbidities to speak of. I was approved in about 4 weeks.

Good luck!

Vikkator · 05-27-2008, 02:30 PM

Wow, CiCi, so you lost 124 pounds! My doc says I should weigh around 122 for my height. How long did it take you?

VanessaSFL · 05-27-2008, 02:42 PM

No problems with UHC. In fact I never heard a word from them just had Dr submit and they approved.They sent me a nice letter...saying they had reviewed my submission and "We can help you"...I cried.

Love love love UHC...keep in mind ...the Employer has a lot to do with what they want in their insurance policy.

Best wishes~

rappaport · 05-27-2008, 02:44 PM

As previously posted, UHC approvals are very dependent on what level of coverage your company has prescribed to. I'm fortunate enough, well, in this case, to work for one of the biggest, and they fully support WLS. They also provided a case worker who followed me along the way and was there if I ran into any issues. My approval took less than a week, unfortunately, I went with a surgeon who is extremely popular and with the year end holidays and people rushing to get it done before their coverage ended for the year, I had to wait almost four months from approval to surgery. But it all ended up being the right time for me anyway.

mommyto-3 · 05-27-2008, 03:37 PM

I'm also in the process of getting things in order to get approved. I just spoke with the lady that handles all the insurance issues for my surgeons office. I also have United Healthcare and was asking alot of question about how easy they are and so forth. She told me that they are one of the best companies that she deals with. She said they are very straight forward and usually do not have alot of additional requirments(other than the normal ones, bmi,5 yr weight history ect.)Of course like everyone else is saying, it varies with what plan of united healthcares that you have and where you work. All in all I was told it should be a pretty easy process. I forgot to say, she also did tell me that they do always require a psych eval, but thats no big deal

Vikkator · 05-31-2008, 01:38 PM

I did the psych eval. it took the guy 10 minutes. He looked over my questionnaire and said 'it looks like you wouldn't have any problems with this surgery'. (no sh$$!) It cost me $185 to find that out! What a racket. No wonder health care costs are so high. This guy makes $185 for 10 minutes of work! Sheesh! And, don't get me started on the costs of drugs! I just wonder how much a shrink makes in a year. What a sweet job that's got to be.

Anyway, I had my nut seminar on Thursday and started my pre-diet yesterday. I'm on my way and can't wait to get this done.

CiCi · 06-02-2008, 12:23 PM

Quote:

Originally Posted by Vikkator

Wow, CiCi, so you lost 124 pounds! My doc says I should weigh around 122 for my height. How long did it take you?

Hi Vicki!

It took me about 9 months or so to lose the 124 lbs. I dropped pretty fast, and looking back, I would have preferred for it to take a little longer, but that's how my body worked. I really thought once I got to 140, I would be happy, but I kept dropping, which shocked the crap out of me!

Now that I'm around 120 most days, I've been trying to add weight back on. I've been maintaining an additional 5 lbs for a few months now and I'm glad. I don't like that hollow look I get when I'm lower than 125. Guess it's time to change my signature info!

Best of luck to you in your approvals!