NEW WITH THIS...UHC
Hi, I live in MI and I have UHC choice plan, I called UHC and they cover the WLS if I can show proof that I've had a BMI of 40+ for the past five years. The problem is I've only had a BMI of over 40 for the past two years... before that it was 34 and 39. Has anyone else run into problem like this with UHC!?! Plus I don't have records of me on a 6 mouth diet plan. I just started taking high blood pressure medication, would that make a difference? Any ideas on how to get around it?
Also when I called they said I would have a deductible of $500 and they cover 80% and I pay 20%, the question I have is do I have to pay what I owe all at once?
Also when I called they said I would have a deductible of $500 and they cover 80% and I pay 20%, the question I have is do I have to pay what I owe all at once?
With most insurance companies, if you have a comorbidity like high blood pressure, you only have to have a BMI of 35, not 40. So that help you. Although, if you just started taking the medication for it, I assume that means you haven't had high blood pressure for five years. So it might not help you after all. I would contact UHC and ask.
If you don't have records of a six month diet, I assume that means you have not done a six month diet? There is really no way around that. Having high blood pressure will not get you out of the six month diet. Start the diet as soon as you can.
Whether you have to pay the portion that you owe all at once is up to your surgeon and the hospital where you have surgery. Some will take payments, but some want paid before you have your surgery.
Kelly
If you don't have records of a six month diet, I assume that means you have not done a six month diet? There is really no way around that. Having high blood pressure will not get you out of the six month diet. Start the diet as soon as you can.
Whether you have to pay the portion that you owe all at once is up to your surgeon and the hospital where you have surgery. Some will take payments, but some want paid before you have your surgery.
Kelly
Hi,
Like the other poster said. You have high blood pressure and maybe they can check you for sleep apnea. My surgeon said that is kind of a shoe in if you have sleep apnea.
You will need the 6 month diet. Jjust take that time to learn all you can about all the surgeries. It seems like a long time when you start but it goes be really quick. Most of us had to do the 6 month and it isn't that bad.
Good Luck
Like the other poster said. You have high blood pressure and maybe they can check you for sleep apnea. My surgeon said that is kind of a shoe in if you have sleep apnea.
You will need the 6 month diet. Jjust take that time to learn all you can about all the surgeries. It seems like a long time when you start but it goes be really quick. Most of us had to do the 6 month and it isn't that bad.
Good Luck
Wendy 
1st fill 4cc, 2nd fill 1.5cc 3rd fill 1.5cc 4th fill .5 Total 7.5 cc in my 11cc Realize Band.
Reached 1st goal weight 158 on 6/8/10, My Starting weight 235
Hit final goal of 145 10/25/10
Current weight 143
If you work the band the band will work for you.
1st fill 4cc, 2nd fill 1.5cc 3rd fill 1.5cc 4th fill .5 Total 7.5 cc in my 11cc Realize Band.
Reached 1st goal weight 158 on 6/8/10, My Starting weight 235
Hit final goal of 145 10/25/10
Current weight 143
If you work the band the band will work for you.
I live in WA state and have UHC. I am having surgery Nov. 30th and I started the process Jan 09 Do you have to talk to a nurse affiliated with UHC over the phone? I had one I have to talk to and let her know my progress and she lets me know what else I need to get done. At the beginning she told me I had to get a cardiac and pulmonary clearance because of my HIgh bmi (over 60) and I needed 5 yrs of weight history.
I told her I did not have insurance the last five years and have not seen anyone to be able to record my weight. She told me they would LIKE to have the five year history but it is not MANDATORY.. and I did not have to do a 6 month supervised diet. Only diet I had to go on was my endocrinologist put me on a strict protein shake/healthy choice meal diet for a month cause I needed to drop bmi before seeing surgeon.
Also, right now I am getting 80% covered 20% self pay. you will get ur 20% billed to you from everything like labs and dr. visits. With my UHC they did not cover dietician and psychological visits though, so you might want to ask about that. Also, do you have a deductible and out of pocket you have to pay before 100% coverage?
I wish you luck and hope things go smoothly for you. I got surgery approval in less than a week with UHC. :)
I told her I did not have insurance the last five years and have not seen anyone to be able to record my weight. She told me they would LIKE to have the five year history but it is not MANDATORY.. and I did not have to do a 6 month supervised diet. Only diet I had to go on was my endocrinologist put me on a strict protein shake/healthy choice meal diet for a month cause I needed to drop bmi before seeing surgeon.
Also, right now I am getting 80% covered 20% self pay. you will get ur 20% billed to you from everything like labs and dr. visits. With my UHC they did not cover dietician and psychological visits though, so you might want to ask about that. Also, do you have a deductible and out of pocket you have to pay before 100% coverage?
I wish you luck and hope things go smoothly for you. I got surgery approval in less than a week with UHC. :)
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