UHC Choice plus-won't cover?

[Annakris1973 0]

Just got off the phone with UHC....the guy on the end of the phone sounded like he had no clue. He said that it was not covered. I gave him the CPT code, he said it was not covered. So many of you have UHC...I was really suprised. He said to call my HR manager...but it is my DH job, and I don't want to talk to anyone up there if I can avoid it. Any suggestions? Should I just keep calling, or is NO a NO?:lost1.5lbs:

[mommyofthreebs 0]

I also have UHC choice plus as does my friend who is having this surgery. She is covered and I am not. My husbands company chose the insurance plan that does not cover this kind of surgery. :tired I was sooooo disappointed... Anyway, I don't want to go to HR and tell everyone that I am having this surgery. So, I guess this means that I am going to be a "self-payer". After reading what so many lapbanders are saying, it seems that it will be well worth the money.

Good luck and let me know what you end up doing.

Melissa

[CoolBrze198 0]

I also have UHC Choice Plus.. The girl on the phone told me I was covered at 80% with a $1000 dudctible. But I needed to get documents from Dr saying medically necessary. with Docs showing HBP or Obesity related items...But I am not gonna keep thinking this will be covered until I get my benefits booklet in the mail.

Bad part with me, is the Dr said it isn't for me. And I don't have any obesity related items. He just told me I am boarderline diabetic. And the only other thing I have is hypothyroid...

Grrrr.. I think I may be shopping for a new Dr.

Hope all goes well with you all.

Take care,

[pamla68 1]

I have UHC choice plus and I'm covered at 90%. I just have to find out how Dr. Virginia Weaver in Memphis, TN will make arrangements for the 10%. You may want to call UHC. again for a second opinion.

[Andie 0]

I am also with UHC Choice Plus and was told it would be covered if I get a letter from my doctor saying my BMI is over 40. They didn't tell my any % yet, I will have to look into it.

[Bikergirl 0]

Have you tried looking @ the website for information on your plan. I thought the Dr. I am going to use wasn't in my network - but after checking the myuhc.com website I saw that he was and I am making an appointment for a consultation with him this week. Good Luck

[thickchickTEXAS 0]

I have UHC Options PPO all they said I needed was a BMI of 40 and a letter from my doctor! They cover 80% im responsible for the rest not sure how much that leaves me to pay??? They sent my information off either friday or today so the waiting begins

[pamla68 1]

It may also be set on what your HR department covers as well.

[Alexandra 55]

What your health plan covers is strictly determined by YOUR contract, Annakris, so you need to find out WHY the customer service rep says it's not covered. Is it an exclusion on your plan? Is all bariatric surgery excluded, or just banding? Is all weight-management treatment excluded, even if it's medically necessary for the treatment of morbid obesity?

You really have to find out what your contract actually says before you can determine whether there's any point in trying to get surgery covered. If it's an across-the-board exclusion on your husband's plan, there's probably little you can do.

[pamla68 1]

I was shocked that it was covered. Our representative stated that with the effects of morbid obesity, it's less expensive to accept coverage for the band than to have to treat a stroke, diabetes, joint problems, etc, etc.

[Alexandra 55]

I was shocked that it was covered. Our representative stated that with the effects of morbid obesity, it's less expensive to accept coverage for the band than to have to treat a stroke, diabetes, joint problems, etc, etc.

That is a great point to raise if anyone finds themselves in the position fo trying to talk their employer into adding coverage for bariatric surgery to the company policy. Plans like that are either self-funded or experience-rated, which means claim activitiy really affects future rates. Band surgery costs a lot less than a lifetime of care for someone with uncontrolled morbid obesity and all the other issues that can arise.

[mommyofthreebs 0]

Thanks for the replies. I have talked to 3 different people and looked it up myself and it looks like all WLS are excluded from our plan...Bummer. I am still going to do it though. Losing this weight is my top priority right now...other than my children and husband!

Thanks again!

Melissa

[pamla68 1]

I completely understand. My next hurdle (haven't lost a pound yet but I'm optimistic) I will need a TT because of the Kangaroo pouch from 4 c-sections. jeez!

[ROSIEG 0]

Hi friends of crappy insurance. I have United Health Care, and was scheduled for yesterday (2/13/07) to have my banding. On Monday afternoon I received a phone call stating that the hospital hadn't got my approval and I should bring a cashiers check for $16,800, (that was funny) or they would have to cancel my surgery. I have talked to UHC 9 times so far and have been told so many things it isn't funny. I work in a hospital, and if I talked to anyone the way I have been talked to by some of the UHC employees, I would be without a job. There is no manager or supervisor you can talk to and also only one number you can call. You can't voice a complaint unless you go through the claims request - I can't believe I am paying for insurance to be treated like crap. Sorry, just need to vent to someone who cares!!!!

RosieG

[pamla68 1]

That's bull crap, Keep up the fight! It will work out. Stay on them! (UHC)