United Healthcare, help!

[justtobreathe 3]

Okay so I have read several things on here about them and have some questions.

1. Do you have to do a six month supervised diet to be approved?

2. Do you really have to pay up front for your surgery and if so how much estimated? And does that include the deductible?

3. Is UHC hard to get approved through?

4. Also, does UHC cover a Tummy Tuck for any reason? (Like for a hernia?)

Just some questions that have been buzzing through my mind, thanks for input!

[mom2lucky (suznc) 81]

I can answer #2. I work in the financial side of healthcare. These days most hospitals require you to pay any outstanding deductible prior to an elective procedure. They may even estimate your copayment and request that as well. How much you pay depends on your employer's contract with UHC. For example - deductible is $1200 & you have met $200 of it at the time of your surgery. The patient access staff will request the outstanding difference of $1000 + may ask for more if you have an additional copay of 10 - 20%. The reason they do this is because it is difficult to collect money due after the service and this is elective, not an emergency (EMTALA limits what can be done financially for true emergencies). I've seen elective surgeries cancelled due to the patient not being able to come up with funds. As for what UHC requires, Google "united healthcare medical policies" & look for the bariatric surgery policy. The first few pages should provide requirements. You may want to call them to make sure your employer purchased bariatric coverage. The rep can go over the requirements as well. Good luck with your journey. This site has so much support to offer so ask anything

[justtobreathe 3]

I can answer #2. I work in the financial side of healthcare. These days most hospitals require you to pay any outstanding deductible prior to an elective procedure. They may even estimate your copayment and request that as well. How much you pay depends on your employer's contract with UHC. For example - deductible is 1200 & you have met 200 of it at the time of your surgery. The patient access staff will request the outstanding difference of 1000 + may ask for more if you have an additional copay of 10 - 20%. The reason they do this is because it is difficult to collect money due after the service and this is elective' date=' not an emergency (EMTALA limits what can be done financially for true emergencies). I've seen elective surgeries cancelled due to the patient not being able to come up with funds. As for what UHC requires, Google "united healthcare medical policies" & look for the bariatric surgery policy. The first few pages should provide requirements. You may want to call them to make sure your employer purchased bariatric coverage. The rep can go over the requirements as well. Good luck with your journey. This site has so much support to offer so ask anything

[/quote']

Well that does make sense and I can of expected that. Luckily I'll be getting ny tax return here soon so the money will be much easier to save up! Thanks so much!

[lovealways 287]

The best thing to do is call your UHC plan. There are SO many different UHC plans all with different pre-op requirements. It is best to contact your insurance representative directly to find out what they require. My UHC is UHC Community Plan. I was required to do 6 months and a lot of other tests.

[MamaLumm514 2]

Okay so I have read several things on here about them and have some questions.

1. Do you have to do a six month supervised diet to be approved?

2. Do you really have to pay up front for your surgery and if so how much estimated? And does that include the deductible?

3. Is UHC hard to get approved through?

4. Also, does UHC cover a Tummy Tuck for any reason? (Like for a hernia?)

Just some questions that have been buzzing through my mind, thanks for input!

i have uhc and didnt have to do the six month diet, uhc covered my surgery in full i only payed co pays.it took 3 days for me to get approved. not sure if they cover tummy tucks

[lolawaiting 83]

My bro has uhc and has to do a 12 month plan

[pookybear 284]

I had the same question about paying up front. The insurance company told me to call the billing office at the hospital the surgery will be at and ask them. I did and thy told me that they like to get the payment up front, but they'll work with me. She said not to worry, they won't cancel me if I don't have it.

I'd suggest Caplin the hospital and asking them, they are the ones that could tell you what would be required or if they'll work with you.

[pookybear 284]

*Calling the hospital. Ugh.

[justtobreathe 3]

Thanks everyone! The hospital has payment plans and I'm contacting UHC tomorrow so hopefully that all works out!

[lessoflittlebit 8]

I had the same question about paying up front. The insurance company told me to call the billing office at the hospital the surgery will be at and ask them. I did and thy told me that they like to get the payment up front' date=' but they'll work with me. She said not to worry, they won't cancel me if I don't have it.

I'd suggest Caplin the hospital and asking them, they are the ones that could tell you what would be required or if they'll work with you.[/quote']

My hospital said the same - and I'm still on a payment plan for gallbladder removal from last summer!

Louisville, KY ~ RNY June 2013 ~ Sent from my iPad using RNYTalk

[Jacqueline K 93]

I also have UHC.... I have to pay my deductible which is $2000 and 20% (they only cover 80%). 20% for surgeon will be $326 and for the hospital (including deductible) will be about $2900-$3000 (this is only beceause my insurance is an HRA and I have a balance in there of over $800 which is applied toward my out of pocket). I also have already paid the $300 fee my surgeon's office requires for their program- to see nutrition, mental health, and fitness. I will also have to pay $130 for the pre-op diet as they order it for you. My requirements for UHC are that I use a Bariatric Center of Excellence and that I do a pysch eval.... I have to call today to try and set up my eval. I'm looking at surgery date of end of May/Beginning of July because of the finances involved. I've got $1600 saved (and that $300 is already paid).

Surgeon's office told me that as long as I'd completed the psych eval and insurance approved it I could have surgery whenever but I just can't due to the amount of money I have to come up with.

[cathyh 33]

I have UHC and I did have to complete a Dr. Supervised Diet and Exercise Program, after initially being told I didn't last August. Now waiting 2nd time for Insurance Approval, it was sent on April 5th. Good Luck.

[mommashari 55]

I have UHC. Have to do a 6 month doctor supervised diet.

I have to pay co-pays for nutrition classes. The surgery itself, insurance covers 80% and I get billed the rest (after surgery).

I do have to pay psych eval up front.

Do not know about tummy tucks. Good question.

[yasminsnewjourney 52]

I was told by them that they cover Tummy Tuck if you can maintain your weight for two years and supervised by the nut.