United Health Care and Hello Everyone

Hello everyone,

I am new to this part of the site. I had VSG last August. I have lost from 366 to 214. Most of my weight was in my stomach and now I have a big issue to deal with. We had great insurance with Cigna that would cover everything I needed and I met all the medically necessary criteria. However, on Nov 1 our plan changes to United Health Care. I don't have all the details yet, but the plan summary exclused skin removal. It does not give the term " if medically necessary". I was so close to have the Pani removal (  probally would have been in Dec). So right now I am so sad and frustrated. As many of you know starting the process to remove the skin is a big part of this journey.

Any of you out there ever dealt with United under these guidlines and won?

Thanks so much for you time.

I am united healthcare and lost. If your employeer did not add that to their plan that is why. My employeer did not and the only reconstruction they will pay for is breast and that is if you had a mastectomy.  My surgeon and Dr did try but it just did not go in my favor. It's a tough battle if your plan excludes it, but good luck.

Thank you for responding. Thats what I figured, ugh! I am sorry it didnt work for you.

Honestly I knew ahead of time that it would not and it did not even matter.  I owed it to myself as a gift for losing the weight. Let us know how it goes.

I understand! We will do whatever we have to do to ensure I get the surgey(s) I need. It's just a shock right now as we didn't know our insurance was changing. To be so close to getting at least the pani done and now being in limbo has been hard. 
I was just looking at your stats and wow amazing! You have done great!! Can you tell me more about the skin surgey you had and cost? My highest weight was 366.

I tried three times with UHC and lost every round, I think it is worth a try to get it approved once and if it doesn't work may not be worth time for an appeal.  Looking back I wish I would have done this a year ago and gottne it over with rather wait all this time for me file appeals and everything. If you got the cash get it done when you are bottoming out on your weight loss, if I would have done it a year ago I would have went into surgery 20 lbs lighter and I think my results would be alittle better.

We never do know when insurance changing, like she said it's your employer not always insurance that sets the tone for this stuff.

Good luck
Bubba

My surgery is November 8th. I'm having a circumferential lift and brachioplasty (arms) done. I am self pay and my cost includes one night stay in the hospital
10.021.00

Is there anyway you can buy into CIGNA for a couple of months to do this? Would be worth the cost if you could.

I now have United Health care and it excludes any type of surgery and specifically says that under no cir****tance is it covered including after significant weight loss. I didn't try to appeal because lucky for me I had Empire Blue the year before and it was covered.  It didn't cover much in all my surgeries but any little bit helps. I believe my surgeon quoted me just over 6k for a tummy tuck & arms. Do you have any kind of hernia or anything that needs an abdominal surgery? If you do sometimes that surgeon (or your bariatric surgeon) will also do a panni removal while doing the other surgery.

I have applied for my own health care. I believe I will be denied but it will take awhile to know.

I do have at least one hernia and I know insurance will cover that surgery, so I can ask to have the pani done at at the same time for sure.

The cost isn't bad. Your paying yourself and your worth it! amazing!