Will United Healthcare pay for my gastric bypass surgery?

Question

My doctors have deemed it medically needed and my BMI is a 50.18.

Answer 1

I had gastric bypass surgery and it was covered by United Healthcare. I was 5'10 325 pounds and age 20. They paid for about $30,000 of it, and I had to pay the other $7,500.

I lost 100 pounds and my high blood pressure is much better now, and my borderline diabetes is gone.

Hope this helps!

Answer 2

Suzanne's answer is correct. Insurance companies issue health insurance with many different benefit designs. It is possible that a company would cover it for one individual and not another because their policies are slightly different. Don't call. The doctor's office should prepare a plan of treatment and submit it for review before the treatment begins. The insurer will respond with their pre-determination. If you like it, go ahead, if not, you may be able to appeal it. What the doctor says is medically necessary doesn't necessarily match what your coverage says. And find out the maximum it will pay, and your expected out-of-pocket (including hospital and follow-up costs).

Answer 3

:( please reconsider this surgery and try a medically supervised weight loss program. I've seen too many patients with bypass drop tons of weight really quickly, which requires plastic surgery to remove all the excess skin left over from the rapid weight loss, and then slowly resume their prior eating habits as the remnant of their stomach is stretched larger. They end up being as big or bigger than they were before the surgery. Then there are the possible complications from surgery in general, risk of GI hemorrhage, dumping syndrome from food rushing through the GI tract too quickly, possible malabsorption of nutrients, the inconvenience of having to eat many microscopic meals every day, having to carry an identification card that states you had a roux-en-y.... Surgery is just a quick fix that isn't a fix most of the time.

Answer 4

The surgeon's office will have to call to get it approved before they schedule your surgery. If it is medically necessary, then yes....depending on your plan, they should pay part of it. You will have to check with them about how much. Will they pay 80% and you pay 20%?

Answer 5

call your insurance company they should be able to help you with that answer, most insurances will if it is medically needed. However, if you need surgery after wards they will not pay (cosmetic) Good luck

Answer 6

With your doctors support, it's likely they will cover it. You might have to go through a lot of red tape first though. Good luck!

Answer 7

Have you checked with them?

That's the best way.

Answer 8

Yes
I have UHC also.