News on UHC POS

Every so often I like to call United Healthcare to see if I get different answers. They all seem to be consistent. According to my plan, WLS is covered if medically necessary. So, no change for 2004 I suppose. I know some people (including myself) were concerned. They said everything goes through the pre-determination department and they will let the Dr. know what information they need. They would not let me talk to anyone in that department (it's not a "phone" dept) to find out what would generally be needed. *sigh* But still, in the end, they are still saying it is approved if medically necessary.

Hello Marcie, I have UHC Choice Plus, for 2003 WLS was an exclusion, so I was worried, but the 2004 policy covers it if medically neccessary. I think UHC is one of the best ins. co.'s to deal with, even my surgeons office agrees. You'll get approved! Good Luck and hope you get your "approval" soon!

Marcie, I have UHC POS through my company and it also states it is covered if medically necessary. A friend of mine who works for the same company as I do was approved about 2 weeks ago. She had to submit: -- a letter of medical necessity from her PCP & WLS surgeon -- a doctor supervised diet of 6 or more months within the past 2 years -- complete diet history from the time she recognized she was obese. The history had to include when the diet started, how much weight was lost and how much weight was gained back. Also, any prescription or over-the-counter diet pills you took. -- a psych eval after taking the MMPI-2 test -- medical records documenting co-morbids she was claiming to suffer from. I don't know if your policy reads the same as ours or not, but maybe this information will help you. My surgeon requires a little bit more documentation but if I can submit to him all of the information he requires, I've got UHC way covered. ~ T.

i was denied by uhc yesterday. they said my policy has an exclusion. also she told me that uhc is not covering wls any more at all except where it is state mandated. i am in fl. so nothing i can do about it here. no state mandate.

That is very strange. I spoke to someone there who said it was definitely covered. You should seriously file an appeal.