needing help with United Healthcare
Has united healthcare ever paid for any type of bariatric surgery? I think it is a specific exclusion on my policy. But I was wondering will they pay for the cost surrounding the surgery such as the facility fee and the other things and I just pay for the cost of the actual procedure? Can this be done?
I have fought them for three years, my husband has had me call them once a month to make sure as well. They do offer coverage however companies have the option to opt out and save money. Stupid but many companies choose this option. If you need an endoscopy later they should cover it under normal situations. If you have severe life threating conditions that surgery may cure then you can ask for an exception. The examples given to me were severe diabetes or heart disease. There are a bunch of hoops if they accept your exception but it is very rare they will. This is why I am going to Tijuana in a week. Terrified but I did my research and I found a doctor who will do it for much less and has a great reputation. Doctors there will do a sleeve for between 5K - 12k. That is a lot better then the $25,5000 I was quoted here. If you have to pay out of pocket I would recommend looking at that option because if your company opted out then they will not cover any part of the surgery. I am sorry to deliver such grave news.
If there is an exclusion there is really nothing you can do about it. I've never heard of them dividing up the costs unless maybe the surgeon is doing another procedure like a hernia or some other surgery in that area that they can charge the insurance co. for, Even then the ins may not cover the time for the bariatric part of the procedure. There just is no way that I know of to get around it. Sorry, this is where many people end up going to Mexico for surgery.
If there is an exclusion there is really nothing you can do about it. I've never heard of them dividing up the costs unless maybe the surgeon is doing another procedure like a hernia or some other surgery in that area that they can charge the insurance co. for, Even then the ins may not cover the time for the bariatric part of the procedure. There just is no way that I know of to get around it. Sorry, this is where many people end up going to Mexico for surgery.
I have seen recently on here where people who they won their case against an exclusion. Plus I had an exclusion on WLS AND PLASTICS IN 2000 me and my x husband had WLS , we had tummy tucks, my husband got a breast lift and I got approved to get my batwings a d thunder thighs done.
That attorney they promote on here Walter Linstrom had an exclusion and he won his case. plus a lady last week told me she used him and didnt even pay a couple of thousand and he won her case. I believe sometimes people give up to quick. In 2000 3 of my coworkers tried and were denied so they didnt appeal for try again till policy was changed this year.
I had the same problem with UHC years ago, there was an exclusion written into my policy however my surgeons office wasn't made aware of it until they submitted it to my insurance.... MEANWHILE they covered everything up to that point... all the tests that were required pre-surgery. It was a very depressing and upsetting experience. I fought them and fought them and unfortunately got nowhere. I ended up leaving that job and started the process all over again with my new insurance. I wish you the best of luck, I have been where you are and can understand your frustration.
Has united healthcare ever paid for any type of bariatric surgery? I think it is a specific exclusion on my policy. But I was wondering will they pay for the cost surrounding the surgery such as the facility fee and the other things and I just pay for the cost of the actual procedure? Can this be done?
in 2000 UHC was the best insurance have everyone got approved plus if you lost 100 pounds you got a tummy tuck and other plastics if dr said they were medically necessary. I think it depends on what you job pays to put in their policy. I know this year my job puts in that anyone that meets criteria can get WLS. I work for the gov and my job Is self funding so they realized that WLS is cheaper than paying for a bunch of sick people and its WAY damn cheaper than paying out those 1/2 million to 3/4 million life insurance benefits. They know typically we don't carry any add. life ins because its too expense due to our classification and if we get killed in the line of duty our families will be set. So anyways sorry i went off on a tangent....my point being go to hr get your policy and see what your companys policy Is. A lot of co that have exclusions say unless its medically necessary as mines said in 2000. All the drs have to do is say it is and you meet bmi and comorbids if under 40 and you should be able to win eventually. I always say its the ins. co job to frustrate you and make you give up. its your job to get what the heck you are paying premiums for "whatever medical treatment you need to improve you quality of health and extend your life expectancy". What ticks me off is I know my premiums are due every 2 weeks what if I took 15 working days to evaluate if I want to pay them they high Azz premium every other week. I digress.... BUT I DO have to thank GOD until this revision request CIGNA HAS BEEN EXCELLENT TO ME, They approved every request 1st time submitted. With my RNY IN 2000 I filled out a questionare sent it to the dr i had Never seen didn't provide any medical documentation and had an approval and a surgery date in 8 days from the time I requested to get a packet in the mail. It was so fast i called and canceled it and rescheduled it for 2 months later. Hopefully my favor hasn't run out. GOOD LUCK AND HEY DON'T WORRY UNTILL YOU ACTUALLY GET DENIED,
Batwingsman · 5 replies · 1379 views