changing jobs

ninatina_2006
on 12/31/06 6:17 am - Louisville, KY
 I am going to be starting a new job in January. I have Aetna Insurance right now but the company I am going to work for will offer United Healthcare. I have gone to UHC's website but can't find any information as to if they cover WLS or what they require before they will cover the surgery (6 month diet, weight history, etc) If anyone out there has had WLS and had United Healthcare Insurance, I would greatly appreciate if you could let me know what they require. Thanks in advance....
Consultation with surgeon scheduled for October 9. Getting closer.....


MS_mom_1965
on 12/31/06 6:23 am - MS
My UHC begins in January, and from what I was told, a 5 year history of BMI > 40 is required.  I'm not sure how strict they are about that, but I'll soon be finding out.
semperfidad
on 1/1/07 12:25 am - Shelbyville, IL
ArabianRIder
on 1/1/07 2:53 pm - Garland, TX
UHC covers WLS but what you need to know is if the plan your new employer is providing has purchased the benefit.. You see it is not so much if the insurance carrier offers the benefit but if the employer has chosen to buy that benefit.... I work at UHC and some plans  cover it and some do not.... I would  talk to your new employer and see if they  will be able to tell you....If you are hesitant about telling your new employer right now... then my recommendation is to wait til you are enrolled and then  you will have the specific plan information and will be able to access the benefit structure on myuhc.com or by calling customer service The employer also choses the exclusions... I can tell you what my plan with UHC covers and the requirements, but that does not mean your employer has purchased the same one... so my plan requirements would not be very helpfull  to you
MS_mom_1965
on 1/4/07 1:31 am - MS
Arabianrider - can you answer my question?  How strict is UHC on the 5 yr BMI > 40 requirement? My BMI is over 40 now, but hasn't been over 40 for five years - probably over 35 though.  However, I also have high blood pressure.  Do I have a chance of getting approved?
ArabianRIder
on 1/4/07 2:27 am - Garland, TX
The requirements are usually  over BMI over 40 with no comorbid conditions or Over 35 with a comorbid condition... the accepted comorbid conditions for  most plans are Sleep Apnea, HTN, diabetes. You have show a history of  failed attempts at losing wght, but for now you are not required to do a 6 month Medically supervised diet... though with more  companies that are allowing the benefit.. this too may become a qualification in the future... FYI in 2004 UHC paid for WLS for it's employees in 2005  this change  and was not a covered benefit , in 2006 it changed again and WLS became a covered benefit...  and this is continued  in the year 2007 You have a chance... the same Chance as I do ... I am looking now for a WLS program in the DFW are right now I am looking Baylor's program and one at Medical City... I would like to  stay with St Pauls but I do not see a  WLS program run from that hospital... I used to work at St Pauls and have been hospitalized several times and each was a good expereince....  but I want a full service wls program not just the surgeon I have a BMI of over 40, , I have sleep Apnea diabetes and am borderline hypertenive  I  qualified for WLS 4 yrs ago under BC/BS and only  comordid condition at that time was Sleep Apnea... I was not able to have surgery then as I was told I was to be laid off in 2 months... not a good time to set up major surgery, new employer did not offer benefit.   Now that UHC does I am also reconsidering it Hope this helps
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