UHC vs AvMed

I'm really excited..I've had health insurance with BCBS which has the nasty WLS exclusion, so I was losing all hope of ever getting the surgery. I just got a new job and my choices for insurance are UnitedHealthCare, AvMed or BCBS PPO.  Of course I'm not wanting BCBS again, so that one's out. Anyone have any suggestions which I should pick between UHC and AvMed?  I'm leaning towards UHC as I've seen a lot of positive things from people all over the country who got approved without much hassle. I'm in Jacksonville, Florida.  28 years old, 5'3" and 343 pounds and have been overweight by whole life.  Did the sleep study and have sleep apnea, just got diagnosed with Type 2 diabetes..so I've got a few of the usual pre-reqs.  My doctor is on board with the whole WLS thing and even suggested it to me without me bringing it up first when we talked about my weight loss efforts.  I'm not tied to her though..if she doesn't take my new ins then I'll find a new PCP. Any advice about my insurance company pick?  Other than covering WLS (hopefully lap rny) I don't have any other specifics that I'm looking for!  Thanks! 

I work for the State of Fl and have Avmed Open Access and had no problems at all.  It took less than a week after my paperwork was submitted to get approved.  Can't tell you about UHC.  Just check to see if there is a WLS exclusion.  Good luck.

Oh!  That is exciting.  I'm working for the state, too..so I would assume that if I went the AvMed route I'd be covered as well.  I'm glad to hear that..you're the first person I've come across that actually has AvMed, so it's good to hear.

i have bcbsppo and in there book it doesnt have an exclusion for weight loss surgery. i am also on the federal Government plan. i had Pacificare when i had my surgery back in 2002.  i heard Uhc is very hard to get approved. Carla

I was told when I had BCBS that it wasn't covered on any of their Florida plans.  They didn't even mention a rider when I talked to their Customer Care department, but I knew about the rider from some links that someone online gave me that pointed to the rider on the BCBS page.   I don't want to call attention to it by asking my HR department directly, especially since I'm pretty sure they're going to be clueless.  But as someone else replied, if I get the group number I could have the insurance companies tell me directly. I just don't want to identify myself and then that be the reason it ends up getting excluded..pre-existing condition BS or whatever else they'll want to fight me for.

It really depends on the employer and whether they have opted to cover WLS...I would get the member services numbers for all and ask the ins. companies.  I have BCBS of TN and my hubby has BCBS of NC and his covered and mine did not...  Good Luck & Best wishes Dana

I have UHC and WLS is specially excluded in my plan. Like someone else said - it depends on the employer and what they include in the plan.
Maybe you can get the group number for each from your HR rep and call each company to see if WLS is covered before making the choice.

Good luck!

Just because UHC or AvMed covers WLS doesn't mean YOUR employer bought the rider for that coverage.  Some employers do not buy the rider for that insurance to cut on costs and thus it becomes an exclusion.  

So, I'd call my HR dept and ask specifically if WLS is covered with each plan.  I'd call each insurance company and give them the group policy number and ask them also.  THEN get it in writing from each company AND your HR dept.  

You need to do a LOT of foot work on your end before you chose a provider.

Good Luck 

Everyone else is right....it depends on your employer's contract.  I was fortunate to have my my WLS in 2003 before United Health Care excluded the surgery from our coverage.    They paid all my expenses under Health Care Choice Plan. FL health care  Insurance, as a whole, started excluding the procedure from plans in 2004.  I wouldn't know what to advise, except be persistent if you feel WLS is your ONLY choice for good health.  Best of luck. luvitsunnyv

I also work for the State of FL and was approved by AV-MED, but, you have to go through all of their loops.  Talk with some on at AV-MED and ask them for their profile for WLS.  They will send it to you and then you will know everything you have to do before hand.  I was turned down first time because I did not have a documented 6 mos of supervised dieting w/i 3 yrs - this is a must.  Good luck with your new job and joining the looser's bench.   God Bless