United Health Care POS-not having 5 yrs of being MO

My sister is in the early stages of being approved for surgery(RNY), she lives in southern Indiana and her surgeon is in Kentucky. Well, she just received word (verbal) from her insurer that she has been denied due to the fact that she does not have 5 years of being MO, she just has 2 years of being MO and 5+ years of just being overweight. She is waiting for the offical written paperwork of what the exact wording is on the denial. Has anyone with United Health Care POS gotten around this kind of a denial? She is gearing up for an appeal in the near future but she is waiting for her offical written paperwork. Any info that you may have would be appreaciated. Thank you.

what are her medical issues being obese? those need to come into play...see the ins name such as united does not mean anything it is in the policey itself...i had cigna and fought their dumb ass's and then got united and was approved in a minute no questions asked...same for my husband with united....now we have anthem and they suck just about as bad as cigna did but in other ways....our united was the best...

The coverage for WLS is not an issue for her. It is a benefit with her policy. I know what you mean about Cigna, they suck also. My husband was denied with them because of the 6 month doctor's supervised diet trys even though they said initially that it was medically necessary for him to have surgery blah, blah. We did not fight them because he had an automatic coverage with my BCBS PPO of IL policy, they paid for his surgery. One of her co-morbids is depression, I am not sure if she has a high BP, GERD or anything else. Thank you for your response. I am trying to help her all I can because she is new to this game.

I understand about the insurance companies, I was with Cigna and was denied because of not having the 6 month weigh in with a doctor, my company switched to United on 1/1/6, Dr Huse office submitted by paperwork to them on 1/4/6 and I have my approval letter in hand in least then 2 weeks later and was having my surgery about 5 weeks later. My opinion is to appeal when she get the official word.