Need Help Understanding United Healthcare Policy Wording

[Mvpo8961 1]

Is there a way to change jobs to a hospital that does offer it? M

[Wheetsin 714]

I have UHC Midwest EPO. Here's an extreme high-level of my coverage:

Deductible

Deductible Individual: None

Family: None

Out-of-pocket Maximum

Individual: None

Family: None

Office visits

Plan pays 100% for PCP or specialist after $20 copay

Hospital stay

Plan pays 100% for inpatient and outpatient stays. $250 copayment per inpatient admission

Surgery in a hospital

Plan pays 100%

Prescription drugs

You must use a pharmacy in the Medco network.

Generic: Plan pays 100% after the $10 copay

Brand-name: Plan pays 100% after the $20 preferred, $40 non-preferred copay. Your copay is for a 31 day supply at a local drugstore. Two copayments per 90-day supply through mail-order for maintenance medications

Lifetime maximum

None

[Wheetsin 714]

As for your options - do you have coverage through a national provider, or the hospital locally? I know where my parents live, their hospital has its own coverage, and hospital employees do not have other choices provided. Local state employees have the same coverage... so if that hospital doesn't offer it (and they do not offer WLS), then employees can't have it.

Would financing be an option? There are places that will finance procedures. Some hospitals will also let you make payment arrangements with them directly.

[NurseTeresa 0]

When I started at the hospital we had a choice between UHC and Anthum...I loved my Anthum. Then there were issues as to what they were being reembursed through Anthem.....next year UHC only last year and again this year. Then after we were assigned UHC they resigned a contract with Anthum. Sucks to be us. We were told if we wanted this surgery being it is elective to them then it has to be paid in full prior to admission. When they had the Anthum and the UHC my first year there it was offered and had no issues with Anthum for WLS and UHC did pay for it as well. Not as readily but they did. Now nothing at all. I also have thought about your suggestion to a part time job somewhere that covers the surgery.....but most companies don't offer part time benefits like that. Plus you don't know what the coverage is until you are employed with the company. Thank you so much for the brain storming for me. I also have to say I am extremely jealous of your insurance coverages. I pay out the a*$ for mine and it literally sucks. Co pays for sripts went up....what i paid $10 for in dec is not $30. I went into health care for better benefits and insurance. Sometimes think I was better off as a hairdresser with little of anything......Sigh!

[tann 2]

have you thought about a HELOC loan on your home, or refinancing, or some other type loans.