Question:
Has anyone had the lap band surgery and is on unitedhealthcare?

I am looking into having the lap band surgery and when I called my insurance co. they said that I didn't have to have a refferel for the surgery and that after my deductable is met that they cover 100% of the surgery. This just seems to good to be true. I keep reading about people who have to have all kinds of test run and who have to go through six months of a low calorie diet with a doctors supervision and things like that. Is it possible that I could really have it this easy? Does anyone know anything about this insurance?    — electricj (posted on March 8, 2006)

March 8, 2006
Catina, I know I have just started the process. When I called the insurance company about if they cover and how much, they said yes. I figured since my copay was like they pay 70% I would have to pay the remainder. Well the lady told me that since it was a in-patient thing they cover 100%. Everything! From the anastiolgist all the way down. I was so shcoked, I called back 2 days later and got someone else and they told me the same thing! As long as I was morbidly obese they do the surgery. And since it was in-patient the cover 100%. I was shocked. When I had my appt for the first step, the jsut getting started stuff, the insurance lady at the Dr office told me that with my insurance as long as I was over a certain BMI they cover it and I did't have to do all the things the other people have had to do. No 6 month diet, and all the other things. I have been in shock. that is why I am trying to get things rolling before they change their mind. LOL Good luck with everything!! Sheila
   — Sheila_E

March 8, 2006
Believe it. My husband and I both had UHC at the time of our surgeries, and we paid maaaaaaaaaybe $600 out of pocket for copays and whatnot. UHC is a dream come true. I always said my insurance was what kept me at my desk at work, and I meant it. Losing it was my only regret when I decided to leave my job.
   — Jeanie

March 8, 2006
I have UHC PPO as well and it's true I didn't have to go through any of the things some people had to go through. Good luck!!!!!!!!1
   — mamita093

March 8, 2006
I have UHC PPO as well and it's true I didn't have to go through any of the things some people had to go through. Good luck!!!!!!!!1
   — mamita093

March 8, 2006
I have UHC and they have been great! I was told in advance by a friend when I was selecting my insurance carrier that other carriers do not make the process as easy as UHC. I was approved in 7 days.
   — thecjones

March 8, 2006
UHC leaves the definition of medical necessity up to your doctor, where most other insurance companies let that decision lie with them. If your policy covers WLS and your doc says you need it, they will pay for it. However, at the time I had surgery (01) Lap Band was not an approved procedure but the RNY was. That was several years ago and they may now cover banding, I don't know. As for the referral....there are VERY few UHC policies that require referrals any more, however they will want to be notified of an elective inpatient stay. This is generally done when the surgeon submits for approval. Now.....cover all your bases here, the phone people at UHC aren't fully trained in the specifics of claims payment or approvals, most of the more indepth stuff is forwarded on to people that are in the know. Good luck, if your policy does cover the surgery you want, UHC is the best company for the lack of hoop jumping. :)
   — RebeccaP

March 8, 2006
Yes, it is very posible that they have cut out some of the pre- testing. However, If your surgeon does not run some of those tests, which are for your own good, I would find a different one. They are necessary to see where your health is prior to having any kind of surgery. So take to heart that you don't have to do the diet thing. (that is great) but, if he or she does this surgery with out some kind of testing on you, I would run away quickly. Just my opinion. Good Luck, You sure won't regret ever having this surgery. You will have a LIFE again. Marilyn, the Bearlady (2yrs out)
   — Marilyn C.