Anyone have United Healthcare???

[emtsusieq 0]

I got my approval today from uhc. I have not got the letter yet but I called today and they told me I was approved and the letters went out yesturday. my Dr office summitted my paperwork elet. at the beginning of the week and they made a approval in the same week. GO UHC for being on the ball.....

[Hoping2LoseBig 0]

I am really impressed with UHC judging by your responses. I hope I have similar luck!!

I have UHC Choice Plus POS. I called and I was told they would cover based on BMI over 40 and the 5-year weight documentation. I have both of those and they have been submitted to UHC for approval.

In the meantime...I have my first visit with the surgeon in three weeks. On the information I received at orientation, they told us that there is a $300 fee just to meet with the surgeon on that first visit. If I have not yet received approval on the surgery from UHC, does that mean I will have to pay the $300 that day? Or would UHC cover it as a regular co-pay? Anyone have experience with this?

Also, for those of you who have been covered by UHC for this surgery, what kind of out-of-pocket costs did you have? I know all policies are different, but I'm still curious on an average of all your costs (doctor's visits, psych evaluation, surgery, fills, etc.)

Thanks in advance!

[emtsusieq 0]

My plan covered my inital visit with the midsouth bariatrics. the only thing i had to pay was my $20.00 copay. There office did all my paperwork and sent in for the approval , my pcp did not do anything except write me a letter and refer me to them. I was told the only out of pocket cost would be the my $100 ded to the hosptial. The office and ins both told me this. with that said I may have to pay a $500 to the office for ongoing support with psych and nutl. They told me all clints have to pay this because the ins will not. I am checking into this because I can have twenty psych visit a year and now my nult visit on the other hand i have to pay for my ins will not cover this cost. they did cover the inital one with on the $20 copay but stated anything after that i would have to pay for. So at most i am looking at $600 out of pocket cost. plus any copays for fills.

[Hoping2LoseBig 0]

Wow, EMT, that is not bad at all. I'd love to have insurance cover 100 %, but I'm thinking I can deal with around $600 or so. So I'm assuming everything had been filed and approved before you even had your initial visit?

[emtsusieq 0]

I just called the ins company after my free seminar and ask if it was covered.. they told me Dr woodman was a in network provider and yes it was covered 100%. So i went to the initial visit April 1st and only paid the $20 co pay. at that visit they went over everything uhc wanted to cover it. but at that time nothing had been sent in. My paperwork was just summited to uhc 4/20 and on Friday i called uhc and they told me they received all the paperwork from Dr Woodman's office and I was approved. The Approval letter went out 4/23 in the mail. I have been amazed with uhc being so quick. I work in a dental office and have been dealing with ins company's and they like to give you the run around but i will say i have been impressed with UHC

[pephlin 0]

I am approved!!!! I found out when I went in for an appointment on Friday the 24th. I am scheduled for surgery on May 19th. I am sooo excited. They told me that I would have to spend the night, that is what my insurance requires. Did anyone else with United have to spend the night?????

[Juniper 0]

I'm with UHC, and so far I've had to get a Nutrition Consultation, and a Psych Exam, but those requirements were from the Doctor, not UHC.

UHC is requiring that I get a cardiac and pulmonary clearance, but that's supposedly because my BMI is over 55. I'm working through my PCP to get this, and hopefully it won't take long.

Otherwise, I have to do the pre-op diet for 2-3 weeks (lose at least 20 lbs - again a requirement of the doctor, not UHC) and that's it! No 5 year weight history, no 6 month physician supervised diet.

And my UHC rep said she does approvals within 24 hours of receiving them if all the required documentation is included.

I have to say, it's much easier with UHC than I expected. :drool:

[marko 0]

I have to say, my approval from UHC was laughably easy to get. I needed: ultrasound pulmonary assessment, a little blood work, nutrition consultation, psych evaluation, a note from my PCP. That’s pretty much it, in fact I did the first three things all in one day. They asked for a supervised weight loss history, I gave them an old Jenny Craig evaluation form from about five years ago (from a center that’s now closed, no less), and they accepted it. All in all, about three weeks from start of process to approval. Another person I work with had a full bypass; he tells me they went for it with almost no questions asked.

It all depends on how much of a plan your employer has worked out with UHC. My company has a pretty comprehensive plan, so they tend to go for these kinds of things with little strum und drang. Your company may have a lesser plan, and you might get some hassle. All you can do is try!

Edited May 1, 2009 by marko