getting approval from United Healthcare Choice

I called UHC and was told the company I work for doesn't pay for weight loss surgery. I wasn't told anything about medically necessary surgery just that I would have to pay for the surgery myself. Has anyone had experience with UHC Choice. I work for Pinellas Suncoast Transit Authority and their isn't any hope of getting help from them to change the policy. Thanks, Betty

i have united healthcare PPO and i had no problem with approval...all i needed was a letter from my pcp saying that it was medically necessary and a bmi over 40

this is good news! can you share more info on this? i have UHC PPO as well and even though my PCP sent a letter reccomending the surgery they are requesting proof of a monitored diet. any ideas? did you have this?

Get a copy of your policy and read it thoroughly. I also have UHC but I have Point of Service (POS). My coverage is actually written in the exclusions area. You are entitled to a copy of the insurance you pay for, ask for a copy and read every little exclusion. I wish you much luck. I was approved by UHC/POS in less than a week. It makes me so angry that people are denied.

Thanks Shayna, I got the copy of uhc policy and weight loss surgery is in the exclusion unless it is medically necessary. Now if the Dr. will also say it is medically necessary simce I have 100 lbs to loose, have high blood pressure, knee and ankle pain and feel like I can't take do anything without being out of breath. Thanks, you have set my mind at ease because I have read the policy. Thanks, Betty

Different tiers of insurance plans vary and some do not cover the surgery. Your employer may have opted not to pay for the tier that would cover weight loss surgery. It sounds like your insurance plan won't cover the surgery, medically necessary or not.

hello betty! I have united health care choice and I was told it was covered and when we sent off for approval it was denied because there is exclusion to my plan. Am going to try and appeal it but Im waiting on a benefit booklet we never got one.

Sherry, My UHC also has expenses for procedures intended primarily for the treatment of morbid obesity unless medically necessary. Hopefully with my high blood pressure, arthritis and pain in my ankles , knees and back and shortness of breath I can qualify for the surgery. If not, I don't know what I will do. My whole life has been one diet after another losing some weight only to gain it all back then some more. I underwent testing at Florida State Univ to help one of the professors get her PHD and she fould out that my body slows itself down to keep from burning its own weight. No matter how much I exercised They couldn't get my heart rate high enough to burn fat. It's in my genes. My grandfather wwas 400 lbs and my mother was 350 lbs. I am the smallest one of all of my sisters. My Mother struggled all of her like to lose weight. I frequently get nauseated after I eat and a few years ago I was told by a doctor I had a hiatial hernia. I feel like a butterball and I'm embarassed by the way I look and see no way out except surgery. Thanks, Betty

Betty, I have UHC and had WLS last December. My husband's company has had UHC for 8+ years without ever having changed thier initial coverage and thankfully it included WLS. (Some employers dropped it due to rising popularity of the surgery, thus increasing cost). I was approved in 4 days and my bills were paid (with the exception of $275.00 hospital deductible) in less than 30 days. Good luck. LuvitsunnyV@goal

Ruthanna, First - you look great. Now if I can find a doctor who will take me as medically necessary. UHC doesn't cover breast reduction but a co-worker just had that surgery because her back hurt because of the weight of her breasts. So maybe there is hope. Thanks for your encouragement. Betty