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Insurance

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Bullwinkle

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I keep reading posts on these boards about insurance, and the need to document the information I get from the insurance company. I guess I'll write it down here.

 

Thursday, 11-02-06, 6:30pm, I called the toll-free number on the back of my husband's UHC insurance card. After pushing a few buttons to get through to customer service, I talked with a man named LeLand. I asked him this question (straight from the paperwork supplied to me by Dr. Curry): "I am inquiring about my policy benefits on surgical weight loss. Is surgery for morbid obesity a covered benefit? In particular, I'm inquiring about lap-band surgery.

LeLand: "Yes, it is. Lap-band surgery is a covered benefit."

Me: "May I please give you the code for this procedure and would you please check to see if this particular code is covered?" I gave him the code.

LeLand: (After sighing and acting like I was a pest) "Yes, that code is a covered benefit."

Me: "What information do you require before approving the surgery?"

LeLand: "You have to have a BMI greater than 35."

Me: "What else?"

LeLand: "Ma'am, just have your doctor's office call our care coordinator and they will work out the details. This procedure IS covered by your husband's insurance policy."

At that point I just thanked him and hung up because he acted like I was just a huge pest. What I SHOULD have done was stay on the phone and gotten all of the information from the paperwork Dr. Curry supplied to me.

Now I'm scared that if I call the insurance company back, I'll "tip them off" that I want to have this surgery done, and they won't put me on the policy. My husband just enrolled me this past week, and I won't be effective until 01-01-07.

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I keep reading posts on these boards about insurance, and the need to document the information I get from the insurance company. I guess I'll write it down here.

Thursday, 11-02-06, 6:30pm, I called the toll-free number on the back of my husband's UHC insurance card. After pushing a few buttons to get through to customer service, I talked with a man named LeLand. I asked him this question (straight from the paperwork supplied to me by Dr. Curry): "I am inquiring about my policy benefits on surgical weight loss. Is surgery for morbid obesity a covered benefit? In particular, I'm inquiring about lap-band surgery.

LeLand: "Yes, it is. Lap-band surgery is a covered benefit."

Me: "May I please give you the code for this procedure and would you please check to see if this particular code is covered?" I gave him the code.

LeLand: (After sighing and acting like I was a pest) "Yes, that code is a covered benefit."

Me: "What information do you require before approving the surgery?"

LeLand: "You have to have a BMI greater than 35."

Me: "What else?"

LeLand: "Ma'am, just have your doctor's office call our care coordinator and they will work out the details. This procedure IS covered by your husband's insurance policy."

At that point I just thanked him and hung up because he acted like I was just a huge pest. What I SHOULD have done was stay on the phone and gotten all of the information from the paperwork Dr. Curry supplied to me.

Now I'm scared that if I call the insurance company back, I'll "tip them off" that I want to have this surgery done, and they won't put me on the policy. My husband just enrolled me this past week, and I won't be effective until 01-01-07.

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