Question:
What are the requirements for UHC?

I am in Illinois and right now have been denied by Cigna(suprise) and I was thinking about switching over to United Health Care but I would like to first know how the are to deal with and the requirements. Thanks, Sherri    — sherri M. (posted on July 16, 2003)

July 16, 2003
Dear Sherri...as you will soon read, each insurance has their own different requirements in and of themselves. I have UHC Choice Plus, live in Florida, and had absolutely the easiest time with them! I was approved for the surgery at my initial consultation! My BMI was 42ish with no comorbidities. They paid all but $300 that I was responsible for. This was over a year ago, so I don't know if things have changed. Good luck to you! MaryBeth Post op RNY -105#
   — MaryBeth R.

July 16, 2003
Me again...I forgot to mention that I did NOT need a letter of medical nec from my PCP, nor did they require a pysch eval. My surgery was done 3 hours from home, so my doc did all the pre op tests the morning of my surgery. It was all very convenient for me! MaryBeth
   — MaryBeth R.

July 16, 2003
I have UHC in Kentucky and had surgery in Feb. I was approved in two weeks!!!!!! They had no requirements. I had several tests that were required by my surgeon, not the ins. I did not need a referral from my pcp and my letter of medical necessity was sent in by my surgeon after the results of all my tests were in along with my list of past diets. None required by ins. but by the doc. Hope this helps. good luck
   — Delores S.

July 16, 2003
I have UHC Tennessee, and was approved in 2 weeks. Had surgery just over 5 weeks later. I had to be at least 100 lbs overweight with at least 2 co morbids or have a bmi of 50 or higher. Mine was 49.9, and I had 4 co morbids.I had to have 5 yrs of medical records, at least 1 6 mos supervised diet in the last 24 mos, psych consult (the shrink had to write a letter stating I knew what I was doing and was mentaly prepared for the challenge) and had to provide my entire diet and exersize history. They wanted at least 3 documented attempts. I didn't have to have a letter from my pc, but asked him to include one, and I included a letter stating why I felt I needed WLS. The longest part was getting the appt with the shrink and taking the mmpi(or mmip don't rmember which) and waiting for the results. It didn't help he went on a 5 week vacation just before he got the results back. They also pd 100% of the cost minus the 200 deductable, and I don't have to pay if the doc decided to charge more than they agreed to pay. (I realy like that part.) I'm 12 weeks out now, and down 54 lbs. They are one of the easiest insurances.Good luck and God bless!!
   — mellyhudel