My United HC exclusion....

Hiya, just wondering if anybody is able to clarify this, more info on my profile, but the jest of it is this: Called UHC to get a clear(er) definition on my employers exclusion on WLS. It states in my information that an exclusion exists for....... Services or supplies for obesity, weight reduction or dietary control, EXCEPT when provided for treatment of morbid obesity. Morbid Obesity is a condition in which an individual: a. Is greater than 100 pounds or 2 times over their normal weight b. Has been so for at least 3 years, despite documented unsuccessful attempts to reduce under a Physician monitored diet and exercise program and c. Over the age of 25 **********My question is this: How long must the "documented unsuccessful attempts to reduce" be for? *************** UHC says they don't know!!!!!!!!!!!!! HUH?????????? Seems like this is a good thing, I meet A & C, and the 3 year part of B. Thankx in advance!! You guys rock! I most likely won't be able to respond til tomorrow night, but I will check back! Brandi

Brandi, I do not believe there is any minimum length of time for those attempts....of course common sense would tell me a few days or a couple of weeks would not be acceptable. A month or two for each attempt probably would. To be sure before you submit, I would ask for a someone above the CSR to clarify. Not sure from your message if you only spoke to the CSR you got, or if others at UHC were involved w/your answer. A funny thing I found out today...I posted that I now have my surgery date...but they called back, thinking I was wanting the band and that isn't covered by UHC on my particular plan. Got it straightened out. Check out WHAT PROCEDURES they will cover for you as well! Take care, MMM

Good idea, I didn't even think of asking which surgery! I did speak with a care coordinator and 3 CSR's. I think I am going to go with my original plan of having a 3 month attempt, and proof of weight for the last 3 years. Thankx for the advice! There is soo much more I think I am overlooking, I write down EVERYTHING in my profile, then I go look at somebody elses, and think "wow, that didn't even cross my mind". LOL! Congrats girly!!! Brandi

Aetna actually requires at least one six month period of medically supervised weight loss attempts with at least monthly weighins and chart notes. But they also require a 5 year history of obesity with at least yearly weigh-ins so 6 months might be more strict than what your carrier requests.

Brandi, Email offline on this one, as I'd rather rnot post what I did. LOL! Blessings, -Perry 358/325/278/210 Perry P. Perkins Christian Novelist Just Past Oysterville: Shoalwater Book One Read chapter one - (www) perryperkinsbooks

Perry, I didn't get an email from ya and am simply gonna DIE from curiosity, can you try again? LOL!!! Thankx! Brandi