United Healthcare

[johnnycantrock 71]

Have a PPO Plus with UHC and it involves a $300 annual deductible. My dr's office says I owe them $545 and now I'm worried that I'll have to pay the hospital some $$ the day of surgery. I was told I would only have to pay $300 out of pocket (not including co-pays for doctor visits.). My plan states that they pay 100% after the deductible and my deductible is $300. IDK why all of the sudden I'm paying an extra $245 to the surgeon, and possibly a second fee to the hospital.

Anyone else going through anything like this?

[Heathermarie0407 67]

I wonder if you somehow went out of network? I also have UHc but my plan covers at 80/20 after a 500 deductible. My insurance also covers different things at different rates like with our dental for example minor work is covered 80/20 but major is 50/50 so I wonder if something crasy like that is going on

[johnnycantrock 71]

Called my insurance. Everything is in network. My deductible is $300. I've already paid that to the surgeon's office. My insurance said once it posts to my account then I shouldn't have to pay a dime more. The problem is my surgeon is billing me an extra $246 for administration fees. But agreed to accept the $300 as a down to have the surgery. So me, the surgeon, and the insurance company have to have a sit down on why I'm paying extra out of pocket and who is going to reimburse me if I do.

[Heathermarie0407 67]

Wow hope you get that worked out!

[johnnycantrock 71]

All worked out!!!

[Ready for the change 40]

What all did uhc require of you

[nikkiluv 0]

I have united healthcare and a few months ago i called and I had to meet requirements such as bmi of 40. When I called again they said those requirements are no longer in place but based on case by case and documentation. Anyone had any experience with this? Any insight into whai I can expect? I have first surgeon consulation on May 10th. Any info would be greatly appreciated.

[kah1213 311]

I think a few months ago it was decided that people with bmi of 30 or higher might be eligible for Lapland as opposed to 40+ bmi. I think it's case by case, but usually if youre under 40 bmi, you need to have 1 other problem like sleep apnea, etc.

[Heathermarie0407 67]

I just got approved by Uhc about a month ago and I am having surgery may 10th. I was required to do a six month doctor supervised diet, towards the end of that I had to have a psyc eval. And of course all the normal stuff bmi over 40 or 35 with comorbs. I am 5'2 260lbs so I was well over 40 bmi. Once all the paper work was submitted it was about a week and a half.

[phatkatblue 45]

i've been getting bills too and have uhc..my husband and i actually as he is banded too...it's annoying, but i call them and they have been taking care of it...they can't seem to figure out why i keep bills...i wish they would because each phone call with them is at least 30 minutes...well worth getting rid of all these bills we keep getting...

[Heathermarie0407 67]

What's your plan and how much did you end up paying out of pocket?