United Healthcare

At the beginning of the year my employer is switching from Cigna (which has been horrid ) to United Healthcare. I've noticed on the insurance board that UHC seems to be a bit more lenient in their coverage of WLS, but I was wondering if any of you have UHC and may know what criteria they require for approval? Any insight would be deeply appreciated. THANKS

sorry not sure of criteria they ask for u can call Dr.Rosses office at spartanburg regional they may be able to help and yes cigna is horrid they rarely pay for this surgery but i have heard UHC is pretty good about approving so good luck to you . BTW what surgeon are u going with or have u just started?

According to Dr. Ross' office, the criteria are the same for Cigna (100 lbs overweight or 40 BMI with co-morbidities ~ I'm 100 over w/ co-morbid), a psych evaluation (which I'm getting in 2 weeks), a nutritionist's eval, and possibly a 26 week weight loss program within the past year (which I working on now), so hopefully I won't have any problems. Dr. Ross is my surgeon and I began proceedings on all this in June, but it's been slow-going because I could never get straight answers from Cigna. Thanks for your response!

I have UHC and they have been wonderful during my whole process. They require you to be 100 lbs over weight, unless you have other problems. You'll need a referal from you PCP. Any weight loss tips tried in the past will help alot. I hope this helps and good luck in your journey,,,

Hi! I'm both 100 over and am having problems, already have the referral from my PCP, and a detailed history of weight loss attempts, so I'm hoping that's all they'll need. In the meantime, I'm proceeding with the Cigna criteria for the rest of the year until we change over and I can file again and see what's said. According to Dr. Ross' office, the criteria probably aren't very different, but UHC is considerably more open and forgiving when it comes to approving the surgery. Thanks for the good luck wishes. It really means a lot.