An insurance question from a newbie

Hi,   I have a couple of questions: 1) Does United Health Care (Choice Plus) cover WLS? 2.) Here are my stats: 254/5'11/42" waist/depression treated with medication...also anxiety/maybe stress incontinence./35 BMI..IS there any possibilty that I would even qualify for the surgery--I would like to get lapband Thanks!!

United should cover unless your employer has an exclusion. My insurance had an exclusion when I first submitted. I fought it to no avail, but they later reversed the exclusion and I was approved. I think if you have co-morbities like diabetes or sleep apnea you can be approved with a BMI of 35. Without co-morbidities it is usually a BMI of 40. Good luck! PS I just remembered that United did not cover lap band. But that was a couple of years ago... it could have changed.

Hi, I have United Health Care(Choice Plus).  I called and they said they do cover WLS.  I didn't ask for a particular kind of WLS. When I went in to see Dr. Chung about the Vertical Sleeve Gastrectomy they contacted UHC and were told that was an approved WLS surgery.  I'm still waiting for written approval from them. I was told it usually takes about 3-4 weeks from the time the Dr. sends in the pre-approval paperwork. You might want to give them a call and ask specifically if lapband is covered.  They should be able to tell you. Good luck, Jo

Thank yall so much!!  I am going to call tomorrow to my insurer and see what the deal is.

I have 2 insurances Benefit Managment (primary) and United Healthcare (secondary) and both insurances covered my RNY Gastric Bypass. I am not sure, but with a BMI of 35 I don't think you would qualify for surgery without comorbids (medical problems). I was weighting 309 prior to surgery and am now 3 months post-op and am down to 225 (84 puonds). I feel great and have more energy now than I have ever had. Hope this helps! Good Luck! Titania

Hi curlilox...welcome to OH...wow i am surely not an insurance expert by any means...i am fighting a battle with insurance over here myself, and it is very fustrating...the best advice i can give you is to dive in head first and see what you come up with...your BMI @ 35 might be a problem especially without any co-mobilities...but since you want a Lapband you might have a shot you never know...go for it!...i wish you luck...Dreamz

Wow!  Thanks for all of the replies! I called my insurance company this morning and they said that they don't pay for weight loss surgery...I guess my employer made them exclude it from their policy. Oh well.  I did go to a Weigh****chers meeting today so maybe that will help me out...I did okay for a while on it but I kind of fell of the wagon. I wish all of you the best of luck with your weight loss!!

Don't think you can get around an exclusion. I was denied initially and they laughed at me when I tried to file an appeal because of the exclusion.

I unfortunately had to pay cash but it was worth it.

I have UnitedHealthcare Choice Plus and it covered it, but it depends on your employer.  They may have an exclusions in there.

Well, UHC has not approved me for Vertical Sleeve Gastrectomy.  They have approved Lap Band or RNY.  I've done a lot of research and want the VSG. I'm starting the appeal process.  Don't know if it will do any good, but it's better than out of pocket. Jo