Question:
Looking to see who has been approved with United Healthcare PPO???
Does anyone have United Healthcare PPO??? Have most of you been approved for 100% coverage, or does the doctor need to be in network?? IF you've been approved, can you tell me what sorts of requirements they gave you? My surgeons office is sending out my letter, but I'm trying to get an idea of what to expect. Thank you, Kelly — KELLY R. (posted on October 23, 2006)
October 23, 2006
While I no longer have UHC's PPO plan one thing I do know is that I went
through hell with them when I had to have dental work done.
See, I am allergic to local anesthetics and my major madeical was supposed
to kick in and pay the anesthesia charges. Even with a letter to the doctor
and the hospital I ended up paying over $800.00 out of my pocket after they
approved the charge.
I fought with them for months and months to adhere to their promise to me
and to the doctor.
My doctor's office finally threatened ME with court action and I had no
choice but to pay it. I spent so much time fighting them years ago over
this that I finally just wrote it off because I couldn't keep taking the
time to fight it.
Make sure YOU get a letter stating they will cover it if they agree to it
and that it is on letterhead. That way if you decide to take them to
arbitration or court, at least you stand a chance to force them to pay up.
— Merredeth
October 23, 2006
I have this United Healthcare PPO. I think they are good. However if you
read my profile you will see what happened. To make it short they are as I
said good, its the employer you have to check because alot of them are
having the exclusion to weight loss surgery, no if ands or butts period
they will not pay if the employer has a exclusion and this is NOT United
Healthcares fault it is the choice of the employer. It costs more in
premiums so they exclude it. I was told by United 100% coverage and gave
them all the codes to be sure and yes I was covered, well my surgeons
office got the letter NO, exclusion with employer I also did get that
letter a week later from United. I have had problems with vbg so United is
paying to have it taken off and I will then have the RNY which I paid cash
to have that while he has me open. Good luck to you, just remember check
with employer as United will say your covered and then BOOM the BOMB
drops.. Just my experience. Hope it helped..Dawn
— Dawn K.
October 23, 2006
Kelly, I have ppo w/ United health care. I would love to talk to you about
it. Please email me at [email protected]. I went thru a company
called Lapband solutions and handled all of my insurance info. All I had to
do was give them my insurance info......and they took care of everthing
from there.
Katie
— kfraser79109
October 23, 2006
Sorry about that, my finger accidently hit the enter button.... anyway it
seems that they have a dummy book for every topic... Carney Wilson has 2-3
books out which are pretty informational as well as entertaining, etc. All
you have to do is go to the book sites (B&N, Amazon, etc) type in
"bariatric surgery" & "Weight Loss Surgery" and it
will give you a list of books. If you don't want to buy them, check them
out at the library. Hope this helps you
>>>>>>>>> :-)
— Kari_K
October 25, 2006
I was approved in less than a week with UHC PPO. My employer followed UHC's
standard guidelines which was good news for me. The standards were BMI of
35-39 w/ comobidities or 40+ w/ no comorbidities. No 6 month diet, etc. It
is treated like any other surgery so I have to pay 80% after my deductible.
Give them a call and they can tell you what's in your policy. Be careful
because there are several different plans and it might not be as simple as
mine. Good luck!
— Kim-KY
October 25, 2006
sorry... I meant that I have to pay 20% (insurance pays the 80%)!
— Kim-KY
November 7, 2006
I have UCH PPO and in the beginning had a horrible time getting approval.
Was approved then told because the year changed they no longer covered
surgery then 2yrs later started the process over and got approval within
two weeks. I used a in network dr and ended up only paying $325 out of
pocket.
Best of luck!
Natalie
— nrfun
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