Encouraged after speaking with insurance

I just made the decision over the weekend to pursue WLS, so I called my insurance company today to see if gastric bypass is covered under my policy. I was told that it is covered and that they pay 100% of the cost if I meet the criteria, but they wouldn't give me the criteria. They said my surgeon would have to contact them for the criteria and then send in the predetermination letter. I feel like this is good news, but thought it was odd that they would not give me the criteria. Is that normal? Anyway, it feels good to know that they do pay for the surgery. At least I have a shot. I'm pretty sure I should meet the criteria since I weigh 240 pounds, have joint pain, PCOS, blood pressure problems and all the other fun things that go along with being a "big girl". I've spent my entire life dieting and failing. I'm ready for a permanent solution so I can enjoy the rest of my life.

Get the ball rolling girl. Get together as much evidence as you can to give to your surgeon. The insurance will pay but be prepared to jump through some hoops to satisfy them.

Shelia, Are you 100 Lbs or more over weight? And How tall are you. These 2 things are a diffrence maker for allot of Insurances. And alot of them say your BMI has to be at least 45. I went through Arkansas Rehab because my Insurance had an exclution and Your BMI for Arkansas Rehab has to be 55 or more. So it just Depends. Hugs and good luck on the rest of your journey Debbie Moya Dr. Baker 9/22/03 354/188/147

I had the same insurance that you have. The requirments were easy to meet. I have a BMI of 40 and no "serious" comorbidities. I provided a 5 yr weight history and medical records. They do require you to have a psych consult and a letter of referral from your PCP. They didnt require me to have any dr supervised wt loss programs like some insurances do. Unfortunately they approved my surgery and then my insurance changed due to a change in ownership of my hospital. I know several people that were approved quickly and easily through UHC. I have numbers that i can round up for you once you are ready to submit to the insurance. My info got sent to the wrong place several times until I finally found the correct numbers. So when you are ready...email me and I will help you out.