Question:
Seeking Others Approved By United Health Care

I am thinking of switching ins. since Cigna has denied me because of their 2-26 week supervised diet requirement. I would like to hearfrom others your experience with UHC and what did they require and what info. did you have? I am 5'5 and 245lbs with the typical co-morbs and mild sleep apnea. Thanks a bunch for any help, Sherri    — Sherri M. (posted on July 21, 2003)


July 21, 2003
Hi...I have UHC PPO...I received an approval within 2 weeks. My BMI was 40...I am 5'3 and my starting weight was 230...I had no co morbities either. UHC was very easy to deal with ...good luck!!!!!
   — renee G.

July 21, 2003
I have UHC POS. They told me over the phone I would be approved. It took about 2 weeks for it to become official though. I like them. They're good on the phone. Really took their time with me.
   — mrsmyranow

July 21, 2003
Well I have UHC EPO, It has been 3 weeks and still no word. It is all supposed to be done over the phone though....:)
   — Saxbyd

July 21, 2003
I have UHC and was approved in less than 2 weeks! They were awesome. My bill was $26,000.00 and my portion was $150.00
   — Peggy B.

July 21, 2003
I have UHC Select Choice and I was approved in two weeks (not done by phone) My starting weight was 228.6 and I am 5'1". They required nothing of me but my surgeon did. I had to have all the usual test except sleep apnea. But, as I said, this was required by my surgeon not the insurance.
   — Delores S.

July 21, 2003
United Health Care was wonderful. They have several different plans, and when we switched insurance companies, my husband called to see which of their plans covered it 100% and that is the plan we chose. We got approved without after the first letter. Be patient with talking to machines and not people sometimes. It gets a little frustrating. Good Luck
   — anadrama

July 21, 2003
I have UHC Select Choice and I was approved in two weeks (not by phone). I started out weighing 228.6 and am 5'1". They did not require anything but my surgeon did. I had to have all the required test except the sleep apnea. But, as I said, not required by the insurance but my surgeon.
   — Delores S.

July 21, 2003
Sherri, There seems to be a common misnomer on this website that UHC approves practically everyone. I just want to caution you to look into what type of policy it is. PPO is most likely to approve. HMO is more difficult. I have UHC Choice Plus HMO and I've been denied, I'm going through my first appeal. Not saying it's impossible, just sometimes difficult. Feel free to email me if you have any questions. Good luck!!! :0)
   — SweetDragonfly

July 21, 2003
Hi-- Same height /weight. United PPO Approved after first letter. Have mild arthritis and family history of obesity, little bit of reflux. My surgeon ( Duke University) required a referral from the PCP, a psych eval, extensive labs, but they made it all pretty easy--- they submitted, followed up and in less than 2 weeks I was approved. Also-- fyi-- surgery was 8 weeks ago yesterday. I have lost 38 pounds and have not thrown up once. This has - so far- definately been do-able. Best of luck to you--- I have a good feeling that things are going to work out for you !
   — Louise W.

July 21, 2003
I worked for UHC for 5 years in claims payment. I am not speaking on thier behalf nor am I guaranteeing anything. About 3or 4 years ago UHC adopted the policy to let the doctors and not UHC determine medical necessity. This was a big deal and this is why peoples opinions on this site are that UHC will approve anyone. Because they will, so long as your policy covers the procedure, and you have a qualified surgeon saying that it is medically necessary. It has nothing to do with HMO vs PPO or anything of the sort. The working envoronment at UHC is unreal with the fact that it is preached that you do everything you can to get benefits for that claim or that member. I can not tell you how many times I heard...'if you can find any way to pay or approve that procedure...do it.' I hear so much bashing of insurance companies on this site, I just can not validate any of it from my perspective. Anyhow to answer your question....bmi of 40, and a letter from my surgeon. :)
   — RebeccaP

July 21, 2003
starting weight of 291 with several co-morbids. Had to have a psych consult, 5 years of medical records, and had to show documentation of 3 supervised diets. I included diet books as well as food diaries. Once submitted, I was approved within 2 weeks, and having surgery 5 weeks later. They are one of the best insurances. Also, if the dr's office sends you a bill for more than the insurance coverd, you don't have to pay it. (I got a $60,000 surgvery for 23,000, and only had a $200 copay)
   — mellyhudel

July 22, 2003
Hello. I have UHC and very similar stats to you. I am 5'5" and started at 237. UHC was great, they took 2 weeks to approve me and I have no complaints about them at all. Feel free to read my profile for additional info. Lap RNY 237/190/130.
   — Dawn P.

July 22, 2003
My policy has an exclusion in it and, as I understand, this exclusion can not be overturned. My company is self-insured with UHC as the 3rd party administrator. My company could override the exclusion, but will not do it. Make sure you check what exclusions your policy has. Read it very carefully and ask your HR department.
   — Terry Lynn W.

July 23, 2003
I have UHC PPO and was approved in less than 2 weeks. I submitted the following: 1) Letters from my Endocrinologist, Pulmonologist, Psychologist and General doctor; 2) A spreadsheet listing 10 years of dieting (surgeon only needed 2 yrs but I got carried away.) Only two were with doctors and all the rest were fad diets, diets I invented, details on laxative and enema use plus exercise programs. That was it. Good luck!
   — Oneida H.




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