United Healthcare approval BMI 41.5

Megan F.
on 11/18/11 9:35 am - Avon, IN
RNY on 04/27/12
 Does anyone have experience with United Healthcare and insurance approval? All they are requiring of me is 5 year weight history and a psych eval.  I also have sleep apnea.  I am concerned that because my BMI is just above the 40 mark that i may not get approved initially or they will try to fight me.  But i also have the co-morbidity of sleep apnea.  I am 26 years old. Please let me know of your experience or any information/recommendations you may have.... I am looking for a ray of positivity on the whole thing so please?? :) I haven't yet submitted to insurance i am still waiting on my history from 2006 but should be submitting by the end of the week. I'm hoping to know if im approved sometime before christmas. 
Thank You!
"This Too Shall Pass....."
    
HW: 257lbs SW: 252lbs GW: 125lbs        
Price S.
on 11/18/11 10:16 am - Mills River, NC
No experience with them but your surgeons office should be able to tell you exactly what you will need to do, which hoops to jump though, etc.  Most insurance will approve with 35 BMI and co-morbidities or 40   bmi so you should be fine as long as you are going for a surgery that is one your insurance covers.  Mine only covered RNY and bands, no DS or sleeves.

    LW-Apple-Gold-Small.jpg image by PlicketyCat  66 yrs young, 4'11"  hw  220, goal 120 met at 12 months, cw 129 learning Maintainance

Between 35-40 BMI? join us on the Lightweight board.  the Lightweight Board
      
 

Crabadams72
on 11/18/11 11:01 am - Silver Spring, MD
Sounds like you will be fine. I was approved with a bmi of 40 and my co-morbidities were not severe. If you can, contact the UHC bariatric coordinator and ask her via email what the requirements are.
VSG 6/10/2011  Dr. Ann Lidor BMore MD 5'5 HW-247 SW-233 GW-145 CW-120
        
http://www.youtube.com/user/72Crabadams   Me rambling about my journey : )

Megan F.
on 11/19/11 5:45 am - Avon, IN
RNY on 04/27/12
 thank you!
Shari S.
on 11/18/11 3:43 pm - Loganville, GA
I had a BMI of 40 and was confirmed in just a few weeks. That was 1.5 yrs ago. As far as history, I only had to submit weight loss attempts listed by ME, not from my doctor, and I went back over 10 yrs to show all the attempts I'd made to lose weight (WW, Jenny Craig, Nutrisystem, etc). I DID get a letter of recommendation from my PCP too, because the surgeon requested it for submission to UHC.


Shari        
MacMadame
on 11/18/11 3:46 pm - Northern, CA
My surgeon says they are easy to deal with.

I have them now but not when I had my surgery and anyway WLS was excluded from all policies my company offered (because they suck).

HW - 225 SW - 191 GW - 132 CW - 122
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Starting BMI 40-ish or less? Join the LightWeights

Kiminey65
on 11/18/11 11:02 pm
RNY on 10/25/10 with
Well, I have BC/BS so I know that is different. I was astounded that they approved me on my first submission. Believe my, your surgeon's office knows what to do!

I had a BMI between 36 and 37. I did have a 5+ year history of obesity. Also with several attempts at weight loss. I did have moderate sleep apnea too, and was approved immediately.

Hope that makes you feel better. 
                
Megan F.
on 11/19/11 12:10 am - Avon, IN
RNY on 04/27/12
Thank you! That does make me feel better...the one person i know personally is really positive about it for me because she was approved right away but then I get online and read about so many people that have to appeal and I get negative.. Everything will be better once i just get the approval I am so impatiently waiting for.
Megan F.
on 11/19/11 12:08 am - Avon, IN
RNY on 04/27/12
Thank you everyone for your information.  I am just so anxious to start my new life and I am so nervous.  I feel like I could be getting my hopes up and getting excited for nothing if I don't get insurance approval.  I am having a hard time sleeping right now too because I obsess about getting approval. I just can't wait for approval so I can finally sleep again and can start getting really excited about getting healthy and finally being happy with myself.
ruxanby
on 11/19/11 10:46 am
I have UNC and I was approved on 1st try. My plan did not require the  6 mo waiting. it was a piece of cake.  I have not co morbids and had a BMI of 42 ( I think) to start.  Good luck.
Sheri F.   
LW-Apple-Gold-Small.jpg image by PlicketyCat
                                            
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