Question:
How hard is it to get approved theough Unicare PPO?

My company just swiched to Unicare PPO Classic from Aetna HMO. I had gotten denied through Aetna because I could not show proof of a medically supervised diet. I was wondering what does Unicare require and how hard is it to get approved. Thanks for any input.    — Michelle Y. (posted on July 5, 2001)

July 5, 2001
I have Unicare PPO (actually, it is PPOM for Michigan, but the same thing). They have been suprisingly easy. My surgeon sent a letter of medical necessity on a Friday, and the next Wednesday Unicare called their office to request the following: my Psychological eval, a letter from my PCP stating that I was medically ok to have the surgery, and a lab test showing that my thyroid was ok. We faxed everything back to them this past Tuesday, and the surgeon thought I would know somehting within a couple of days. The only diet info we sent was my history for the last several years in my letter of medical necessity. It did include Weight Watchers from October 2000 to present, but I have never tried something that was specifically classed as "Medically supervised", and they didn't require it. I think as long as you have all your information together and ready to go, they should be fairly easy to deal with. Have you had your psych eval? I would get one ASAP, as some can take a while to get. As far as I can see, that would be the only hold up for you.
   — mregalad

July 5, 2001
Hi Michelle, I checked the "insurers" link on this site and then checked your state, Texas. Although plans will vary greatly within the same insurance company, I am happy to report that Unicare approved everyone that I saw listed. (except one that was waiting for a reply). If you check out this link, you will also get e-mail addresses for those that have this insurance. Maybe you could ask them their specific experience. Just go to the top of any page and click on "insurers". Hope this helps. Shelley
   — Shelley.