Question:
UHC PPO Gastric Bypass

I've recently been denied the gastric bariatric surgery with BCBS, my company is switching to UHC in Jan 11'. Does anyone the know the prequalitions for UHC? Would I have to start the BMI weigh-ins all over again? Should I be on a Nutri system program now?    — snowglobe (posted on October 18, 2010)

October 18, 2010
UHC requires weights with your Dr every six months for two years. That you have tried to lose weight and been unsuccessful during that time, either losing enough or keeping it off. I don't know which procedure you are looking at but they also pay for the sleeve.
   — goldnhart

October 18, 2010
I just had to have a 6 month history with my doctor of my weight and to prove I've tried to lose weight with little success. Actually, they were very easy to get approval. I had no trouble. My sister also had UHC PPO and her company has a weight loss exclusion. So I guess it depends.
   — Christy Sanchez

October 19, 2010
I would suggest you call UHC My approval came withing a week with no preconditions. In my PPO plan with UHC, there is a limit of one wls in lifetime. Also, if you know who your surgeon will be call his/her office and ask to speak with their insurance coordinator and ask for their understanding of the UHC rules.
   — MrsBacchus

October 22, 2010
I Just started, UHC requires 3-6months weigh in depends what employer requested. Ours is 6months within last year with weigh in every month can not miss a month.
   — Kim_M

October 24, 2010
It all depends if your company chooses to cover it. if so, you need a 12 month weight history within the last two years, and a BMI over 34 with existing conditions, or BMi over 40 without any pre existing conditions,weight related of course. Also make sure you choose a doctor that is contracted with a Center Of Excellence, if you do not, they will Deny you! That is what happened to me anyways. I would have saved myself a year if I would have known that! Good luck!!
   — a_new_me79

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