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United Healthcare Insurance Question...



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I am about to get United Healthcare Insurance at work, and I don't yet have all the documentation and resources to figure out what they may or may not cover. I had Blue Cross Blue Shield a few years back that paid for my Lapband surgery. I'm wondering if United pays for plastic surgery, and if they do what do they consider medically necessary???

Here's the situation:

-I have backpain because of my chest, even after losing 75+ pounds.

-I get rashes, spots, sores, boils, etc on my inner thighs because they got WORSE after losing weight, just sag and rub!

-I get rashes and "acne lookin' spots" under my lower stomach "hang".

I have not told any doctor about these problems because I haven't been going to the doctor regularly (no insurance) but I have been documenting it all in pictures. I don't think I'll be having ANY surgery until a few years from now...(I think) because I hope to lose a little more weight and we may decide to have a baby...so surgery would be have that, at least the Tummy Tuck. So if I could do the thigh lift now, it wouldn't affect a pregnancy AND I'd be able to run more, maybe even faster!

My doctors DO know that I'm an athlete, I've been working really had to get/stay active and that I (feel like I) have to wear Spanx during workouts to keep my skin all in one place so it isn't bobbin' all over the place.

So I will see my family doctor AND a dermatologist as soon as my new insurance goes into affect, tell them what's going on, show 'em the pictures and have them document it all for me. I'd just like to be ahead of the game if I can. If they'd pay for part of it, I'd do the inner thigh lift in the next 6 mths!!!

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What they cover will depend on what your employer group wants them to cover. I have UHC also and mine does not cover plastic surgery at all but yours may be different. The premiums are based on the options the employer group chooses. Our employer group chose to cover bariatric surgery with very few requirements but no plastic surgery.

As for the thigh lift, if you are planning to have a baby I would NOT get it done until afterwards. I only say that because when I got pregnant the first time my thighs were fine and normal sized but by the time I was 9 months preggo they were stretched out, saggy and full of stretch marks. I've been wanting my thighs done ever since then. When you are pregnant you tend to hold a lot of weight from Fluid retention which can settle in your thighs.

Does your BCBS cover plastic surgery? Is the United Healthcare coming from that same employer?

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What they cover will depend on what your employer group wants them to cover. I have UHC also and mine does not cover plastic surgery at all but yours may be different. The premiums are based on the options the employer group chooses. Our employer group chose to cover bariatric surgery with very few requirements but no plastic surgery.

As for the thigh lift, if you are planning to have a baby I would NOT get it done until afterwards. I only say that because when I got pregnant the first time my thighs were fine and normal sized but by the time I was 9 months preggo they were stretched out, saggy and full of stretch marks. I've been wanting my thighs done ever since then. When you are pregnant you tend to hold a lot of weight from Fluid retention which can settle in your thighs.

Does your BCBS cover plastic surgery? Is the United Healthcare coming from that same employer?

Thanks for replying! No, my BCBS was through a different employer. My UHC goes into affect 10/6/11, yayyyyy!

I have 2 boys already and I'm about 80% certain I won't have anymore kids. And if I did have the thigh lift and had another pregnancy, it wouldn't be more than 1 more kid, AND I have much better control (mentally and psychologically) over my weight now so I'm optimistic I wouldn't gain a lot. Plus if I did choose to have another child, I would wait until after I got to my goal weight anyway.

I just feel like I NEED this thigh lift. I talk to other women in my life and it seems like the issues I have with them are abnormal...and it's such a hassle. Also a constant reminder of the size I used to be. =/

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I know what you mean. When your insurance takes effect just read your policy closely and then call and speak to a customer service rep. With my UHC plan I ended up speaking with several different reps and then a supervisor. My UHC pays well but their reps aren't very knowledgable and have a tendency to give me incomplete or incorrect information.

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