Dealing with United Health Care

I need to know if anyone has dealt with United Health Care (PPO).  They say WLS isn't covered unless medically neccessary, and then you jump threw all there hoops and get letters, records, etc and then they still turn you down.  I'm waiting for answer to my first appeal letter, and keeping fingers crossed. Can someone let me know how they were able to get approval? Don't want to play games with them but I'm ready to fight if need be and need to know how to go about it.

which united health plan do you have?  Are you a low BMI.  From what I hear most UHC plans approve rather quickly?

I have UHC PPO, and have a BMI of 43 with GERD and high blood pressure.  They have approved several people in the agency in the past however they all have had to appeal also, but have since have changed some of the policy regarding WLS.   Thanks

My UHC plan totally excludes WLS.  I'm really depressed about it.  I don't know if I can come up with the $15,000+ for self pay lap band.  Good luck to you.  It floors me how so many people have UHC plans that cover it.  I tried to get my HR manager to get it included in the new enrollment season, but she said she's tried in the past and they "wouldn't budge".  Nice.

  You know I don't get it. Why is it that if you smoke or are a drug addict there are programs to HELP you. In DE even the wealthy can get state help to stop smoking.There should be a law against this. I am sick to death of people saying weight is OUR fault. Just put down the fork. Shut your mouth. Workout. It really boils my blood that in our society where we so don't want to offend people the overweight are still picked on.     It took me an entire YEAR to lose a simple 40 and I worked out on ave 2 hours per DAY! I eat less then my thinner counterparts. My own doctor didnt even believe me at one point so I stopped going until I got pretty sick and he was suprised that I had lost weight. I bit my tounge and simply said I TOLD you I was working out and I dont eat pasts or white breads and NEVER sugar. Gee so they finally do blood work on me and I have sugar issues NO kidding!I am "stuck" at 210 and no matter what I do cant get below that weight.    I will keep you in my prayers. There is a group in Mexico that is offering a holiday special for 8000 all inclusive including fills,plane tickets and a stay at a 5 star resort hotel. They also offer more treatment options including some ballon type device that only stays in for 6 months.

  Go to msn search and type in UHC choice plus does it cover lapband     That is the EXACT search term I used and looking at results people ARE being covered good luck.

Hi, I have UHC PPO and they covered my VSG. Qualifications are different with each insurance even if you have the same UHC PPO due to the type of insurance package your job offered. I have seen another person with UHC PPO get approval right away and with no restrictions. I, on the other hand, had to do a 12 month doctor supervised diet before I could get approval. I was first denied due to the fact that my paperwork I turned into the insurance company was 2 weeks short of the 12 months required. Some others are only required to do a 6 month diet, etc. My insurance packet said the same thing, "Unless medically neccessary," but they didn't tell me what else was required until I was denied. Whatever you do just keep appealing until it is approved. Also, make sure you request for your appeal to be EXPEDITED. This means UHC only has 3 business days to give you an answer. Good Luck,