Daisymae

Got denied by UHC and I'm Angry!

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So I didn't even know that my dr had already turned her stuff in. I opened the letter from UHC and it says that I'm not eligible because I've never done a supervised diet.

Edited by Daisymae

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I have UHC and am waiting for approval. I was told the same 5 years of history and they also asked me all the diets I have been on. I think you have to have a BMI of 50 or higher for the 5 years. So when you go to a doctor they usually weigh you so I think they use that. I didn't have to prove which diets, just let them know to record it. Fight it... maybe they just didn't get enough information from the doctor. Good Luck!

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I will definitely fight it, I'm just annoyed. Like who would be fat this long and just decide one say to have surgery without dieting first?

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I know it's a very expensive thing and they want to be sure you are a good candidate but I already passed the psych consult so you would think that would be enough.

My question is, what is the point of the six month diet? What if you lose and gain it back?

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I never had to do the six month diet...some insurance companies have you do it to see if you can lose weight. My doctor had me do a month but that was her requirement not the insurance. I think you need to call UHC to see what is require sounds different than mine.

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Great. I call UHC and the woman is clueless. I ask what documentation they need from WW and she says "what do you have?" I tell her I have nothing, I need to know what to get.
 

Edited by Daisymae

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I know it's a very expensive thing and they want to be sure you are a good candidate but I already passed the psych consult so you would think that would be enough.

My question is, what is the point of the six month diet? What if you lose and gain it back?

I had to do a 6 month diet I think some places do it to make sure that you are commited to losing weight. I only lost a few lbs on it. If I could have done it on my own I would have ;) I was denied twice by my insurance (3rd time was a charm). You should have 30 days to put in writing why you don't agree with their decision and ask them to reverse their decision. In that letter you should make copies of all your weigh in's at WW, and whatever other documnentation you have. Always remember its better to have to much proof then not enough. Good luck!!!

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The 6 month diet is basically to help the surgeon, to make his job easier. The liver is very fatty and large, and it has to be held up out of the way for the surgeon to reach the stomach and intestines. The dieting for 6 months greatly shrinks the liver and reduces the amount of fat that is in the abdomen, thus making it much easier and less risky for the surgeon/paitent.

Almost all insurances require the 6 month diet. I was only 212 when I went for my first consult, and I still had to do it. Haven't found out yet if i got approved though, so *fingers crossed*

Most of the denials seem to be from some lack of paperwork, a test result missing ect ect.

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No, the insurance paperwork gets submitted based on your first consult weight. I was afraid of getting denied for losing too much weight, that they would tell me I did fine and I dont need the surgery. Losing the weight has never been all that hard for me, its the keeping it off that i cant seem to do. Lost 25lbs for a wedding, reunion, holidy party ect ect then gain it all back plus 10 more as soon as it's over, and repeat. lol

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Right now im waiting for UHC to approve me hopefully...I was not told anything about documentation for weight loss attempts by my surgeon's office & I am a little nervous that his office isnt picking up loose ends....

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Talked to her today, she said if I can prove six months in WW in last 24 months that should work. She said sometime when they inquire at first they don't tell them everything.
 

Edited by Daisymae

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I had to do a 6 month supervised diet too in order to get this covered.

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I had to do a 6 month supervised diet too in order to get this covered.

Me too and it was 8 years ago that I had my GBS done. Its not new for insurances to require it. I think they do it to make sure you are commited to losing weight, because why spend all that money for someone that will gain it all back in a couple years. All though it sucks 6 months really wasn't that horrible. I've been fat my whole life so 6 more months wasn't that horrible considering.

Good luck I hope that the reciept will work for you.

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I had to do a 6 month supervised diet too in order to get this covered.

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I'm just mad because I have been thinking about this for a friggin year. If I'd known this was a requirement I would have started it already.

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I'm surprised your doc's office didn't know. My doc knew what my insurance company needed (I was till denied twice) if they won't take the WW stuff hopefully the times that you have meet with your doc about this will count. Good luck take a deep breath and fight!

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well i met with their dietician so....idk....i didnt really say anything because i thought "well they do this more than me so lol"

I have UHC Choice Plus...idk if the plan makes a difference?

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I'm just mad because I have been thinking about this for a friggin year. If I'd known this was a requirement I would have started it already.

I don't blame you. Thats very frustrating. They should have told you all of this info up front.

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Paul everything I'm reading online on forums says choice plus doesn't require the six months. Sounds like someone at UHC dropped the ball.

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