Gastric Sleeve - Insurance not approving

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amother

Wed, May 04 2022, 10:26 pm

I have letters recommending it from multiple drs yet they won't approve it. Anyone here able to successfully get United Healthcare Choice Plus to pay for it? If not, does anyone know insurance advocates or something like that that I can contact for help?
TIA

amother

Brown

Wed, May 04 2022, 10:37 pm

Have they given you a letter indicating the reason for the refusal.

That would be the first thing because you can't dispute something effectively unless you know what you are actually disputing.

Typically insurance plans have very specific criteria such as minimum BMI or having proof of unsuccessful diets etc.

tripletlyblessed

Thu, May 05 2022, 6:31 pm

Most insurances won't unless through an employer that doesn't explicitly state that they exclude bariatric surgery. (that's been my understanding in the various VSG groups I've looked at.)

My insurance doesn't so I'm paying out-of-pocket and going to Mexico in July. So excited!

amother

Eggshell

Thu, May 05 2022, 6:38 pm

I'm assuming you're already working with a specific surgeon. Is the surgeon's office not able to tell you if they've had patients with your insurance successfully get authorization for the surgery?

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