UHC Question

c1nnamon
on 11/11/13 9:29 pm

I'm thinking about some form of weigh loss surgery. I haven't spoken with doctor yet. I'm trying to decide if there's a chance that UHC would approve me. I contacted them about the requirements and here  is part of  the response that I have a question about.

Bariatric surgery (on an inpatient or outpatient basis) is a covered health service based on the following:

- Covered Person must have a minimum BMI of 40 with documentation of a diagnosis of morbid obesity for a minimum of 5 years from physician; or

- Covered Person has a minimum BMI of 35 for 5 years with complicating co-morbidities (such as sleep apnea or diabetes) directly related to, or exacerbated by obesity with documentation of a diagnosis of co-morbidities for a minimum of 5 years from physician.

My BMI is 39.5 and I just diagnosed as having sleep apnea. The problem is I'm not sure if my BMI has been 35 or higher for the past five years or than during pregnancy. I only went to the doctor consistently when I was pregnant. I had first child five years ago and my last one three years ago. My question is, does anyone know or have any experience with UHC regarding the five year history. Will they consider a BMI less than 35 if it was more than five years ago?

uglymouse
on 11/13/13 12:12 pm - newnan, GA

I didn't have to show 5 years of BMI. I am also with UHC. 

ByeByeLbs77
on 12/18/13 10:51 pm

I just called UHC yesterday, as my benefits start as of 1/1/14. I asked specific questions and was told

*BMI 40+

OR

BMI 35 with medical complications etc.

no 6 month diet, no referrals, no other contributing factors other then informing them prior to surgery to avoid a fee.

 

good luck! :)

Most Active
×