United Health Care - Choice Plus - ThinnerTimes - Gastric Bypass Forum, Lap Band Forum, and Vertical Sleeve Gastrectomy Forum

MattR · 09-07-2009, 11:11 PM

Hello everyone!

My name is Matt and I had an insurance question. I currently have United Health Care. The plan I have is the Choice Plus. I was just able to login to myuhc.com and I see the plan and benefits. For those who have United Health Care and online access where exactly would I go to see of WLS is covered?

Vikkator · 09-08-2009, 05:17 AM

You should call them. I have UHC and it wasn't listed on the benefits page, so I called them and they told me it was covered. BTW, they did cover me and I had no problems with them, but it depends on your employer's agreement with them, so you need to call them to find out.

lvl0rg4n · 09-08-2009, 11:18 AM

Hi!

I have UHC too. Here's where you go:
Benefits and Coverage> Special Services under Benefit Details> Bariatric Resource Services>All authorization information and enrollment for bariatric surgery must be initiated through United Resource Networks @ 1-888-936-7246

I called them and registered, however they said they'd call me back in 3 days, but never did the first time. So I found that I had to call the general number and request to be WARM transferred over to the case manager to be able to talk to her. It was very very frustrating, but now that I'm on a roll, I'm more tolerant.

MattR · 09-08-2009, 02:46 PM

Thanks Vikkator. I'll give them a call ASAP. But based on what lvl0rg4n stated I see under Bariatric Services I see "Not Applicable". It doesn't look good so far.

MattR · 09-11-2009, 05:48 PM

Well I finally called the insurance company and they told me it is covered under my plan with some requirements.

Minimum BMI of 40

Over 21 years of age

Minimum 5 years of documentation that prove weight issue - I haven't gone to a family doctor every year consistently. Where could I get this documentation? I've only been to a dentist office and a weight loss clinic where I remember being weighed.

Require Pre-Certification - I have no idea what this is. I'm sure this is something the doctor has to do or I could be wrong.

poet_kelly · 09-11-2009, 05:55 PM

Pre-certification is something your surgeon will do. He or she will fax all the necessary paperwork to the insurance company for approval.

As far as the documentation of your five year history of being overweight, have you been to the doctor at all during the last five years? Even if you don't have a record for every year, if you have something it might help. Or even if it's something older than five years. Another possibility is to send pictures of yourself from the last five years which show you are overweight. That may not be enough, but it might help.

Kelly

MattR · 09-11-2009, 06:00 PM

Quote:

Originally Posted by poet_kelly

Pre-certification is something your surgeon will do. He or she will fax all the necessary paperwork to the insurance company for approval.

As far as the documentation of your five year history of being overweight, have you been to the doctor at all during the last five years? Even if you don't have a record for every year, if you have something it might help. Or even if it's something older than five years. Another possibility is to send pictures of yourself from the last five years which show you are overweight. That may not be enough, but it might help.

Kelly

I just can't remember. Up until now my weight never bothered me. I know I have been overweight because when I did go to see a doctor for being sick the "weight issue" was always brought up. Is it possible for me to have any doctor I may have seen release my information to me?

poet_kelly · 09-11-2009, 06:24 PM

Yes, you can get copies of any records from any doctors you have seen. They are allowed to charge you a small fee for making copies for you. To save money, you can ask what's in the records (or go to their office and actually look at the records) and just ask for copies of the relevant parts.

Kelly

deeteeceecee · 09-12-2009, 05:43 PM

Hi Matt R

I have the same insurance that you have..When I called they told me the same requiremnts. I had to go back to clinics from when I didn't have health insurance to get my weight,to my OBGYN, and my pcp that I have now.

At 1st I couldn't think of all the doctors that i had weighed in at but it came back to me...I wish you the best of luck..I go see the surgeon on Monday 9/14/09 an at that time I was told that they will fax my info. to UHC for approval..I will keep you updated...

MattR · 09-13-2009, 12:41 AM

Quote:

Originally Posted by deeteeceecee

Hi Matt R

I have the same insurance that you have..When I called they told me the same requiremnts. I had to go back to clinics from when I didn't have health insurance to get my weight,to my OBGYN, and my pcp that I have now.

At 1st I couldn't think of all the doctors that i had weighed in at but it came back to me...I wish you the best of luck..I go see the surgeon on Monday 9/14/09 an at that time I was told that they will fax my info. to UHC for approval..I will keep you updated...

Yeah. I'm going to have to take a day off from work to go back to my hometown to see if they will release some records to me. On a few of these visits I didn't have insurance as well. Its been so long though that I hope they still have my records. What about weigh ins at the dentist's office; would those count as well? I also went to a weight loss clinic a few years back and I remember them weighing me; I thinking these types of clinics get rid of files after a certain amount of years.