Switching to UHC Insurance - Approval Questions

roxannerg
on 11/18/11 12:00 am

My company is switching to United Healthcare insurance as of Jan. 1. I went to a plastic surgeon recently about an abdominoplasty and possible breast reduction.  We're going to wait until after the first of the year to file for approval since I can't get a surgery appointment this year (to use my current insurance).  I read somewhere that UHC will generally approve panniculectomies rather than abdominoplasties....while I don't really need the stomach muscles tightened my surgeon said I can only get rid of my 'upper' stomach with an abdominoplasty (and it's large enough it would look terrible if I had the bottom done and not the top!). Does anyone have experience with UHC and how likely/unlikely they are to approve these kinds of surgeries after weight loss? 

Thanks in advance for any information/advice!

Roxy

358/343/218/195
Highest/Banded/Current/Goal

**Lost 12 lbs on pre-op liquid diet** 
10 cc band: Have had a total of 8 fills and 2 unfills - Currently 
at 6 ccs.
sonnieN
on 11/18/11 12:09 am, edited 11/18/11 2:44 am - grand rapids, MI
Read your companies policy to see if there are any exclusions. My company has UHC and it excludes any type of reconstructive surgery  w/ the exception of breast repair after cancer. It specifically states no reconstructive surgery will not  be approved in association w/ major weight loss or wls. All depends on the riders your company purchased.

ETA my UHC will not approve any reconstructive surgery at all associated w/ weight loss or WLS
roxannerg
on 11/18/11 12:32 am
I should have thought of that...I'll check.  Thanks!
Jujuvee
on 11/18/11 6:14 am
I wish you luck and it all really depends on if your company opted out of that clause, but this was the topic a few days ago and about 6 of us (me included) were denied.

Mine would not even cover the pannus removall. They only cover reconstructive after breast removal. I was self pay.

HW 405- Pre op weight 374- Plastics weight 203 Current weight 194

Circumferential lift/Brachioplasty November 8, 2011

16.3 pounds removed.

Revisions + Thighplasty  October 23, 2012

Breast lift- Spring 2013
 

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