What do you think of this verbage? UHC

Okay, I am in the thick of it and I have an appt with the surgeon tomorrow. Here is the verbage that is on my policy. What do you all think? UnitedHealthcare Limitations and Exclusions This section summarizes when the UnitedHealthcare medical plans do not pay benefits. The UnitedHealthcare Options PPO, Out-of-Area and Select EPO plans do not pay for the following services, supplies or treatments: "For weight reduction programs, unless prescribed for morbid obesity."

Hello Paige! First off, I too have UHC and I am currently fighting them with Gary Viscio after they denied me, but i had a direct exclusion in my policy. Sounds like to me as long as you are morbidly obese that you have a good chance. So I guess just give it a try. Keep me posted on what happens okay and oh yeah, GOOD LUCK! Ruthann

The keyword here is "unless prescribed for MORBID obesity." Make sure you fully understand a diagnosis of morbid obesity and you should be fine. I have UHC and my policy reads exactly as yours does. I had approval within three days of requesting surgery. Just be sure the words "morbid obesity" appear instead of just "obesity" or "overweight." Good luck!!

Thanks Ruthann and Shayna! I go today for my surgeon appt and I am very excited to get on with living. I called UHC yesterday and they said that they have even done approvals same day over the phone. I am not getting my hopes up but am definitley going to fight if they turn me down. I'll keep you posted. Paige

Good luck and let us know. ng

We have United Health care and ours says the same thing. We called them and asked about coverage. They asked BMI, were told over 40 and they said that it was covered submit the papers. It was secondary insurance on me (we didn't tell them that) and my primary insurance also said it covered morbid obesity in the booklet, so we have NOT sent paperwork to UHC. We were checking --- just in case we had to use it instead. Actually, ours said must be medical necessity. We said, How do we prove that, and they said..... a letter from your PCP is enough. I hope this helps you.