Insurance Approval
I was wondering if anyone on here has United Health Care Community Plan MCP insurance and if so, were you approved for weight loss surgery? Was it hard to get approved? I've done a lot of research and I qualify for weight loss surgery. I'm 5'4, 242lbs with a BMI of 41.5. I'm just nervous they won't approve me. I know how insurance companies can be.
If your policy covers WLS and you meet their guidelines, they have to approve you. They can't refuse to provide covered benefits when you've paid for the policy that covers them.
Kelly
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
What Kelly said. As long as you meet all of their requirements for BMI (and comorbidities, if applicable), provide all of the required documentation, and meet any pre-approval requirements (psych eval, diet, etc.), they MUST approve you.
You just have to sure to meet the requirements for approval. Often an initial denial is because of missing documentation, so be sure you know what all they require so you can be sure to submit it the first time around,
Lora
14 years out; 190 pounds lost, 165 pound loss maintained
You don't drown by falling in the water. You drown by staying there.
I have the same plan.. United Healthcare Community of Ohio. I had to get a referral from my doctor which I just did recently and Kings Daughters WLP has accepted me into the program. My first appointment isn't until July but I should learn more from there. I was told that this doesnt guaranteed that it will pay for the surgeon. I am really nervous about it but I am hoping that my insurance company will approve it. Why else would they let me start this whole process?
Because until you start the process, they don't know if you qualify or not.
Kelly
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
