Unicare Insurance

Hi Everyone! Does anyone have any experience with Unicare and thier coverage (or lack there of!)LapBand surgery in the Chicago area? My husband is a Cook County employee and has Unicare....I have been referred by my primary physician for LapBand Surgery. I got the approval to proceed after submitting the paperwork, I am now attempting to get the psych eval that is needed and was told by thier office that Unicare doe not cover anything regarding obesity! :-S I have contacted Unicare on several occasions and am getting conflicting responses! I like to know if anyone had a similiar experience, and if so, how did they deal with it? Any and all info/suggestions will be greatly appreciated. Cheryl :angst:

Dear Cheryl: I had Unicare when I first began to fight for WLS. I had an RNY on 10-27-06--covered by BCBS. In January of 2005, I asked for approval from Unicare, and they said that my policy did not cover obesity, morbid obesity or any treatment of these. I fought them for the whole year, all the way to Lisa Madigan's office, to no avail. At that time though, Unicare DID cover WLS, just not on "small group" ploicies---100 or less employees. My company only had 9 employees. I would think that Cook County should have MORE than 100 employees covered, so you may have a good chance. Ask your husband's HR department for a copy of the policy and look under the "Exclusions" clause to see if it is excluded under your particular policy. Good luck, and keep fighting! Dawn

Hey Cheryl, Well I had Unicare HMO and they covered it in 2003 with no problem, though I had lap RNY July of 2003. Though I had been attending the Northwestern Wellness Ctr for about 2 yrs prior to deciding to go thru with the surgery. They gave me no problem at all and it went thru rather quickly AND they still cover ALL my post opp followup stuff. Going to PPO though next year cuz this referral thing it gotten out of hand. I say read thru the handbook, and there are details as to what is and is not covered too. I remember them saying they don't cover UNLESS doctor feels it is warranted and you have illness associated with obestiy, high BP , diatbetes ect. Good luck... keep the faith

Hello Cheryl, I have been going to the wellness institute at Northwestern memorial for almost one year. I inquired several times to Unicare, I have the HMO, and I am scheduled for the RNY Gastric bypass. Everything is covered 100% as long as you have dr. approval. The wellness institute is great about submitting all the proper paperwork for you, so you can count on them to get you approved. Kathleen (Chicago)

I was informed by a Northwestern financial specialist, (So glad I took the initiative to speak with her on my own) that Unicare HMO requires 18 months of dr. supervised dieting. Well, I only have 10 months so far at the wellness institute, so lucky for me I switched insurance plans through my employer because she informed me that United health care insurance approved with only 6 months and that they approve the fastest, as I am so ready for my surgery. I would have had to wait another year for my surgery, lucky for me my employer has open enrollment going on right now, and my employer also supports WLS! I AM SO HAPPY! So, there you have it. You have to check out all your options and use every option given the chance. I am paying alot more for my insurance now... but it will be so worth it I am sure. Kathleen

I have unicare. They covered lap-band and RNY for me. I was going to get a lap but then changed my mind, so I had to submit for approval again, but it only took 2 days for approval in both cases.