URGENT... I NEED UNITED HEALTHCARE INFO

Good afternoon all, I am happy to report that my company is currently going through annual enrollment (eff. 1/1/06) and I now have the opportunity to change my medical plan from that God-Awful BC/BS PPO. My options are United Healthcare EPO and Aetna HeathFund. I was able to obtain the requirements for approval for Aetna off their website. However, United keeps telling me that their approval is on a case by case basis and they do not have any standard requirements (one website or otherwise). The doctor just needs to send in a letter of medical necessity w/ BMI info and notes. I'm no expert but this just doesn't sound right. There HAS to be some type of guideline that United uses. Is there anyone out their that recieved approval through United EPO recently that can give me more insight as to what they require? Your help is very much appreciated.........

I am also interested in obtaining info for United Healthcare EPO as well. I am also swtiching from BC/BS (could it be we work for the same employer?) to United Healthcare effective on January 1st. I am going to a WLS seminar in December and then hoping to see the doctor in Janaury once I have the new insurance. Can anyone help D. Daniels and I out? It would be GREATLY appreciated! Thanks in advance!

hi I was wondering about the bc/bs,i know alot of people that have had surgery from this insurance plan,are they giving you a hard time?I do know united healthcare also pays for the gastricbypass,becouse i researched it when i had it.Sorry i couldn't be of many more help to ya.Good luck with your quest.Shelly

I have great news!!!! Through my employer I was able to speak directly with an Advocacy Rep with United that was very nice and more then willing to assist me. I was informed that my employer does not have any specific requirements for WLS, therefore, United uses their standard guidelines which are: 1. Letter of medical necessity that includes BMI of 40+ 2. Documentation of morbid obesity for a min. of 5yrs. (a BMI of 40+ defines that) 3. Surgery must be performed by an In-Network Surgeon 4. Surgery must be performed at an In-Network Hospital Can you beleive this? I can't want until Jan. 2nd (I'm faxing over my info for approval). My hopes are to get an approval within 2 weeks and a surgery date before Feb. 4th. I would advise everyone to get in contact with their employers benefit department to find out if they have any specific requirements. If not, you are well on your way. Be Blessed, D. Daniels