Anyone have UPMC insurance?

I have some issues with my insurance. They cover the surgery but their policy is confusing. Anyone have any problems with them? My thing is I have a high BMI (52) but I don't have any co-morbidities. 

Here is is a link to the policy 

https://embed.widencdn.net/pdf/plus/upmc/sdwn1nfe4n/MP.040.p df?u=geyodz

See if you can make heads or tails of it. What I understand I qualify because of my BMI but have to do a 6 month diet (which I'm cool with) but I was told yesterday by my surgeons office that I don't qualify without a co-morbidity. So I called the insurance company and they lady I spoke to agreed with me. But she was going to call me once she looks further into it. 

Take the word of your insurance company over your surgeon; customer service knows the exact specifics of your plan, while the doctor does not.

Looking at this PDF (page 6 and 7) says that for your BMI, you need either a comorbidity OR a successful 6-month diet. Not both.

You'll want clarification from insurance about what's accepted as a "physician-supervised" program-- monthly checkups with your GP? Something with a nutritionist? Make sure to get that in writing from the insurance company.

Thanks for the reply! I got the call Monday from my surgeon office saying I was a candidate. And she set me up for my appts to get started, but the next day called said after she spoke to the insurance company that the policy wasn't correct and we ( me and my surgeon office) read it wrong. So I contacted the insurance company and the woman agreed with me. So now I don't know what to do. Surgeon cancelled my nut. Appt but kept my surgeon appoint. She wants me to get a sleep study to see if I have Sleep Apnea. In hopes I do so we can go forward. 

I'd suggest getting things in writing at this point. See if insurance will make you a document discussing coverage in your specific situation, then give it to the surgeon's office. That way it's the insurance's word, and it'll be the same to both you and the doctor?

I will have to do that! The woman from the insurance company said she would get back to me one to two days. I'll ask her to send me her finding. I don't see the surgeon until the 22nd. Thanks for the input much appericated.  

Hi. I have UPMC insurance and the same BMI. I have no co-morbidities and was approved last week with no problems at all. I completed the 6 month supervised diet. Are you going through a UPMC facility? I've done everything through Magee, so I'm not sure if that has anything to do with it. Best of luck!

Yeah, I'm going through a UPMC facility and Doctor. When I see my surgeon next Monday I'm telling them to we are going through with it no matter what, and if I get denied at the end, I get denied. Oh well, at least I tried! :)

Did you have surgery ? Id love to contact you I'm also doing my 5-6 month diet! Please email me [email protected]

-Lisa