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Old 12-08-2007, 06:53 PM   #1 (permalink)
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Default United Healthcare

I am new to this forum and new to thinking about gastric bypass surgery. I have United Healthcare Choice-Plus coverage. I am asking if anyone has this plan and how much trouble did you have if any with them getting accepted for the surgery. I am 39 yrs old, 6'0'', 325 lbs and suffer from sleep apnea, high blood pressure and chronic joint pain. For the last 5 or six yrs i have gained approx 10-12 lbs a yr. i have tried many diets, and lost some weight only to gain it and some back very quickly. If anyone can answer my question on the insurance topic it would be very appreciated. i have read your forum here and am really impressed w/ the compassion you all have for each other. Thank you for your help.
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Alt Weight Loss Surgery Insurance
Yes, you can often get insurance cover for your Weight Loss Surgery.
Our own Craig "Big-T" Thompson has been there and done that, and he's written an e-book about it.

   
Old 12-08-2007, 06:55 PM   #2 (permalink)
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Join Date: Apr 2007
Location: NY
Posts: 10,175

Weight Statistics

4/19/2007
Surgery Date:
5' 9"
Height:
260 lb
Start Weight:
152 lb
Current Weight:
165 lb
Goal Weight:
108 lb
Weight Loss:
-13 lb
Lb Left to Lose:
41.5384615385 %
% Lost:

Body Mass Index
38.3910943079
BMI Start:
22.4440243646
BMI Current:
24.36357908
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
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welcome! sorry i dont have the same insurance but i just wanted to welcome you to the boards. im sure someone will be able to point you in the right direction.
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Old 12-08-2007, 07:02 PM   #3 (permalink)
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Join Date: Mar 2007
Location: Floyd County Virginia
Posts: 10,106
Blog Entries: 6

Weight Statistics

September 19th 2007
Start Date:
September 19th 2007and June 18,2012
Surgery Date:
5' 10"
Height:
363 lb
Start Weight:
192 lb
Current Weight:
190 lb
Goal Weight:
171 lb
Weight Loss:
2 lb
Lb Left to Lose:
47.1074380165 %
% Lost:
When I get there again
Goal Date:

Body Mass Index
52.0793877551
BMI Start:
27.546122449
BMI Current:
27.2591836735
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
Default

Call that number on the back of your card and ask if they cover WLS. Then If they do sweeite find out what the requirments are. I have seen it go both ways on this board with this insurance. They either cover it or they dont. Good luck and let us know.
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Old 12-08-2007, 07:21 PM   #4 (permalink)
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They do cover the WLS, I am just curious as to how hard it is to get accepted w/ them.
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Old 12-08-2007, 10:39 PM   #5 (permalink)
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Join Date: Apr 2007
Location: Upstate New York
Posts: 757

Weight Statistics

6/16/2007 meda-fast
Start Date:
July 19,2007
Surgery Date:
5' 6"
Height:
325 lb
Start Weight:
187 lb
Current Weight:
150 lb
Goal Weight:
138 lb
Weight Loss:
37 lb
Lb Left to Lose:
42.4615384615 %
% Lost:
no time line i just want it to be lost
Goal Date:

Body Mass Index
52.4506427916
BMI Start:
30.1792929293
BMI Current:
24.2079889807
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
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I dont have the same insurace but I did want to wish you luck and pray that your jurney goes smoothly
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Old 12-09-2007, 10:34 AM   #6 (permalink)
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5' 5"
Height:
Default

Welcome to the board, thank you for joining us.

Your BMI is over 44, you have the co morbidities that are considered candiate for surgery, so you should fulfil the basic criteria for surgery for any insurance that covers the surgery. It's going to be the finer points that will affect what you have to do and how much time/trouble you will have to go through to get approved. The best way probably is to call your insurance co or coordinator and find out the EXACT requirements, such as do they require you to go through a preapproved 6 month weight loss program, or are data from whomever dr you are seeing is enough, etc.

(((((HUGS)))) May your journey go well.
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Old 12-09-2007, 11:49 AM   #7 (permalink)
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Join Date: Sep 2007
Location: New England
Posts: 219

Weight Statistics

Sept 20 2007
Start Date:
April 8 2008
Surgery Date:
5' 3"
Height:
270 lb
Start Weight:
180 lb
Current Weight:
150 lb
Goal Weight:
90 lb
Weight Loss:
30 lb
Lb Left to Lose:
33.3333333333 %
% Lost:
April 2009
Goal Date:

Body Mass Index
47.8231292517
BMI Start:
31.8820861678
BMI Current:
26.5684051398
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
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I have United. I have not been approved yet but I do have a case manager and she told me the requirements are: 5 yrs of BMI over 40, 6 months of those diet classes, phsyc visit. I will let you know more soon cuz I just finished my last class and my phsyc visit is monday so I should be submitting soon.
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Old 12-09-2007, 11:51 AM   #8 (permalink)
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Join Date: Sep 2007
Location: New England
Posts: 219

Weight Statistics

Sept 20 2007
Start Date:
April 8 2008
Surgery Date:
5' 3"
Height:
270 lb
Start Weight:
180 lb
Current Weight:
150 lb
Goal Weight:
90 lb
Weight Loss:
30 lb
Lb Left to Lose:
33.3333333333 %
% Lost:
April 2009
Goal Date:

Body Mass Index
47.8231292517
BMI Start:
31.8820861678
BMI Current:
26.5684051398
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
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oh yeah and you need to have your surgery at a Bariatric Center of Excellence thats the last requirement!
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Old 12-09-2007, 12:35 PM   #9 (permalink)
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Join Date: Jun 2007
Location: Jacksonville, Florida
Posts: 5,174

Weight Statistics

July 21, 2007
Start Date:
August 6, 2007
Surgery Date:
5' 3"
Height:
287 lb
Start Weight:
169 lb
Current Weight:
140 lb
Goal Weight:
118 lb
Weight Loss:
29 lb
Lb Left to Lose:
41.1149825784 %
% Lost:
January 1, 2009
Goal Date:

Body Mass Index
50.8342151675
BMI Start:
29.9337364575
BMI Current:
24.7971781305
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
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I have UHC EPO through my husbands employer...all I had to do was show a 5 year history of being over weight...the surgeon required the rest of the stuff. I went to my PCP and my OBGYN and got 1 progress note for one month of each of the 5 years. I was approved within days. Each and every plan is different though, even if they are the same plan. Your company decides what they want covered and how it should be qualified. I would call and speak to someone at UHC and ask them specifically what is required to get approved then get a call reference number and call back again to see if you get the same answer. When you get involved with that part of the leg work, it really does tend to go much smoother. Good Luck to you!
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Old 01-18-2008, 09:17 PM   #10 (permalink)
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Join Date: Jan 2008
Location: Michigan
Posts: 428

Weight Statistics

January 8, 2008
Start Date:
February 21, 2008
Surgery Date:
5' 7"
Height:
253 lb
Start Weight:
122 lb
Current Weight:
135 lb
Goal Weight:
131 lb
Weight Loss:
-13 lb
Lb Left to Lose:
51.7786561265 %
% Lost:
April, 2009
Goal Date:

Body Mass Index
39.6210737358
BMI Start:
19.1058142125
BMI Current:
21.1416796614
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
Default

I was just approved with United Health choice plus. I had to submit 5 years of weight history, had to be over 21, had to have a minimal bmi of 40 and had to have an approved bariatric surgeon.

Tami
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