Orlando area - United Healthcare?

Hi, I'm a researching fool and would appreciate anyone's help who has United Healthcare. I'm 34 and finally decided to do something about my weight (other than "diet") and I am seriously considering getting the band. Typical story here - yo yo dieter. I've lost and gained a couple hundred pounds over the last 10 years. I'm currently 5'3" and 260. I'm going to try to go with US Bariatric in Orlando for the surgery. I need to know if anyone else has had success with getting United Healthcare to approve the surgery. My plan says that any surgery for morbid obesity is an exclusion and not covered. I also found this article that has me pretty depressed: http://www.zbmi.com/modules.php?op=modload&name=News&file=article&sid=16 However, I did find a place on this site for FL insurance companies and others have said that UHC approved the surgery. I'm confused. Also, if you are self pay, how much are we talking for the lap band? Any feedback is greatly appreciated.

Hi! I used United Healthcare for my surgery. I could have had RNY or Lap band, but I chose RNY. US Bariatric doesn't accept UHC, the last time I checked. Exclusions are done on a per company basis. My company has no written exclusions against WLS, but yours may. I'd ask your HR director for a summary of coverage, and I'd call UHC and ask them to send you the exclusion. Find out if there are ways around it. Best of luck!

Actually, US Bariatric Orlando is out of network with UHC, so we do accept those policies. We bill UHC for those patients with out of network benefits (if they don't have a policy exclusion). We have also had success with HMOs and even UHC Medicaid. Insurance changes so often. Sometimes it makes me want to go live on a deserted island!! HTH, Kristen

Hi Leslie, UHC as a company does not exclude WLS. Whether or not you have a benefit for WLS is a decision made by whomever purchased the UHC policy that you have (for example, your employer). We (US Bariatric) have an excellent success rate for those policies that allow for WLS benefits (and in some cases, even exclusions). The USB Lap-Band self pay rate is $15,595. That includes pre-op education; metabolism testing; EKG, chest x-ray, general labwork; consult with exercise physiologist; surgeon and surgical staff; psychological evaluation; hospital fees and anesthesia. Also, your first year of USB regular doctors office visits and/or adjustments to the Lap-Band are included through your first year anniversary visit. Let me know if you need more information. Take care, Kristen

Thanks, I wrote my HR manager and President of my company a letter today asking them to consider including WLS in our UHC insurance renewal (Up in December). It's a somewhat smallish company and I've been there 6 years. I haven't phoned UHC and asked about the codes that are referenced on this site, but I plan to next week. I did read our policy and WLS is definately mentioned in the "Other Exclusions" part of our policy. I also have an appointment with my PCP on Monday to discuss the band as an option. I have hypertension, PCOS, and boderline diabetes II (if not the flown blown thing). I had a son 3 years ago and had gestational diabetes so I know what a high risk I am in for developing it. So I figure I will get some long needed bloodwork done and go from there. Wish me luck everyone. Leslie

I had surgery through UHC...I believe they approve as long as the individual company offers the service. Mine had the exlcusion..but had "unless medically necessary" which made it possible for me to have it. The next yr they took out those 3 little words and therefore it's completely excluded. Dr. Overcash's office excepts UHC..check with Patrice regarding it..(352) 368-2828. Best of luck

Hi, I am going to have United Healthcare in January. US Bariatric is out of network so I am going to see Dr. Overcash in Ocala. Not only is he in Network but he doesn't have program fees (Dr. Dietrick in Tampa is $1000). I have my consult on Friday.