United Healthcare Choice Plus

Hey everyone! I have been wanting to get gastric bypass since I was 17, but never had the opportunity. No insurance and obviously never had the 30k to pay out of pocket. Also, self pay just really would be last resort for me. Those interest rates kill you! I even thought about going to Mexico to have the surgery done. I've read some really positive things about medical tourism. However, I'd prefer to have it done in the states.

So my question is, I have United Healthcare, Choice Plus with Estée Lauder Co. I've called several times and yes it is covered. My BMI is 50 and they have stated that with my particular plan/carrier that not only do I not need to participate in a weight loss study or program, but I don't need to supply them with a 5 year history of an over 40 BMI.

I even have asked them if once everything is submitted to them, will I THEN get something telling me that it IS required. And they told me "no. It would be in your policy if that was the case."

Is this too good to be true? Am I going to be dissapointed? Anyone out there have a similar experience with this?

Thanks so much!

Never mind I guess! The office coordinator just called me back and told me that not only do I have to do a 6 month supervised diet program, but also offer 5 years of history of having a BMI over 40.

I feel so defeated already. The six month weight loss program really to me, is no big deal. That's absolutely fine, I've waited this long and it'll just get me ready for the lifelong changes I'll have to make.

However, I have no clue how I will provide 5 years of Dr. office visits showing I have consistently had a BMI over 40. For a few years I didn't even have insurance, and so going to the Dr. wasn't exactly possible.

How could I call my provider and get a different answer? Is it that they truly don't know what they are talking about? lol! UHC needs to provide their reps on all the information needed so they can pass it along to us, the people that pay them!

Have you been to a doctor at all prior to five years? If so, make sure those records get sent to the place you want to have surgery. They should be able to help you do this.  Have you attended a weight loss surgery seminar with the center? If not look into one. They are free, and will answer questions and help you get everything you need to do to get what you need to get insurance approval. 

Good luck!

I have a lot of documentation from when I tried to have the surgery back in '07. At the time, the insurance I had did not cover any sort of WLS so I put it all in a folder and filed it away. I still have it, and I plan on using it! I want UHC to know that this has been a life long struggle. Whether or not they will even see it, I want it all in there. Also, my particular Dr. has a great resource available for his patients. Seminars and support groups are offered and I def plan on attending and participating.

Thanks so much

I know this is an older question (im new to the boards) however, i have UHC choice plus and was told no diet and no history needed...just to inform prior to surgery. Can you please tell me how yours went in the end?

The agents that answer the phone really don't know the ins and outs of the UHC insurance.  We only have to do 6 months of super visored diets.. They don't hae to be consecutive either.  As long as it noted   in the notes of goals, and the BMI, adn weight it is good.  

I am hoping my time is up in November.  It would be nice to have the surgery before the new year. 

 

 

Yeah, starting to think that whomever answers the phone is supplied with VERY limited information.

 

Good luck with your surgery and hope you get your date before 2014!

I had United for awhile and what one insurance coordinator told me is UHC almost always demands the six month supervised diet (you will have a nurse calling you to check in), and 5 years of medical records.  The 5 years of weight records can be from anywhere; your gynecologist's annual report when you get your exam is enough, and you can even use ER visits, regular doctor visits, and combinations of the above. Really if it was recorded anywhere you can use it.  

 

I hope that helps!

Thanks so much! Yeah, I'm gathering up any paperwork from any Dr. I went to from the last five years. I'd rather be OVERLY prepared and have more than I need. Better to be safe than sorry!

Get your contract documents and KNOW what is required. I have seen a lot of variability between UHC plans. That document is the contract between you and your insurance company, and they are obligated to follow it.

Good luck!!

Laurie