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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!
Supersize vs. Superskinny is a television show in the UK. They are bringing their show to the U.S. to film here. They are looking for people that are interested in being candidates for their show.
Each candidate will be matched with someone in the UK that will be their partner. The candidate and their partner will work together to on the candidate's weight issues.
If you, or someone you know, in the 500 to 700 pound range, and would like to be considered for the show, please contact us at [email protected]. They will be filming in just a few weeks so if you're interested, email us asap.
I have Aetna and myself and my three kids all had RNY and were approved though Aetna. You do have to meet the criteria in the clinical bulletin 0157 or they will deny. I had to appeal mine and my daughter's denial but we were approved after I appealed. My two sons were approved with no problems but again, you have to do everything that is required in their criteria.
I sent you a PM of all of the information to help you with your approval!
Good Luck!
Nan
Nan
HW 300 / SW 280 / CW 138 / GW 140
Hit Goal 4/2/2010
Thanks so much! I am going to call the number on the back of my insurance card and ask them. I found another post on this site, which was very helpful and it was actually a list of questions that are good to ask your insurance. I saved the link and am going to ask them tomorrow. I am a bit worried because my plan is individual and not through an employer. I am a stay-at-home mom. Perhaps even if it isn't included in my plan, they might accept a letter of medical necessity. Do you think so? Also if I ask would they would send me the documentation? Sorry for asking so many questions! I am just trying to figure this whole thing out and I appreciate every bit of information that you give me. Take care!!
I will keep you posted! I have to call tomorrow though (Monday morning) because I don't think anyone would be there Sunday.
That said, unless WLS is specifically omitted from your plan, I have to think a BMI of 50 is looking like a fairly surefire bet for you. Get your contract documentation to be sure, though!
Good luck to you -
Laurie
Sleeved 6/12/13 - 100 pounds lost to get to goal!
Thanks so much! I figured out UHC is United Healthcare and that is what I too have. Mine is through Golden Rule though. Its the United Healthcare Choice Plus Network, although it is an individual plan too. Have you heard anything else about them approving people? I read people posts on this site and they talk about through their employers they have this insurance and they get approved for WLS.
I have been overweight for over 5 years and my BMI is currently 50.5. I have 4 kids and I really want to get a WLS done. I don't know why insurances make it so difficult. My PCP did recommend it to me before also.
Sleeved 6/12/13 - 100 pounds lost to get to goal!
Sleeved 6/12/13 - 100 pounds lost to get to goal!
Hockeymom87 · 0 replies · 653 views
