Question:
I was wondering if anyone ever get approved with uhc ppo for a gap exception

when their is out of network and your policy don't cover out of network gastric bypass at all and how long befor you get an answer back from the insurance company    — RIANNAH12 (posted on November 15, 2008)

November 15, 2008
No one can give a set in stone answer when it comes to any type of insurance questions. Every single policy is different even within the same company. There is also no way to say how long it will take for you to get either an approval or denial since many different things factor into it. I was approved in less than a week but then there are people who fight for approval for months. There's no way to predict it. I can tell you though that the insurance companies are legally permiited up to 30 days to process your request and even that time frame can be extended if they need additional information before they can make a decision. As far as the out of network coverage, you're saying that your insurance company does not provide out of network benefits at all. If this is the case then you will not be approved. No coverage is exactly that, no coverage. If it's covered only when medically necessary then that's a different story but again, every policy is different. Your best bet is to call the insurance company and find out for sure what your out of network benefits are, if any. If you do have out of network benefits then you need to find out from them what the requirements are for getting approval, for example a 6 month supervised diet, a psych evaluation, etc etc. You want to be sure you have all your eggs in one basket before submitting your request for approval otherwise you may end up delaying things or even get denied.
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