United Hethcare

NewtoYou
on 4/23/12 11:46 am
VSG on 09/10/12
I called UH to see if they covered the sleeve; the lovely little girl said yes. " it qualifies for reimbursement" 

Do you know what this means?  I asked questions, but it was just worded differently than when I had called about the adjustable band.  

Thanks in advance. :)
Kevin H.
on 4/23/12 11:47 am - Baltimore, MD
VSG on 02/06/12
 UHC paid for my surgery.  Just ask them what they require to approve it.  I had to do 6 month diet with doctor and other things.

 
  

PoohHag
on 4/23/12 12:16 pm - TN
VSG on 06/11/12
 
Weird.  My doctor's office is telling me United doesn't require a 6 month diet.   My doctor requires a %, but not the insurance.  Maybe things have changed?
Kevin H.
on 4/23/12 12:31 pm - Baltimore, MD
VSG on 02/06/12
 I just had my surgery in February but it could have changed or maybe its different state to state, I'm not sure.

I had to do 6 month supervised diet, BMI over 35 with 2 serious health conditions, weight history of 5 years from my doctor and other things.

 
  

PoohHag
on 4/23/12 12:14 pm - TN
VSG on 06/11/12
 I have United.  As far as I know, the sleeve is covered.  I'm waiting on one more document before the insurance specialist submits my packet.  


Wildcat-NYC
on 4/23/12 12:23 pm
VSG on 08/16/12
Every plan is different.  I have UHC and my company doesn't require a 6 month supervised diet.  I would call back and ask them what they mean.

The representative that I spoke to laid out everything I needed to do and the percentage that they covered and how much was my responsibility.  It was very clear.  I was even able to verify if my doctor and facility was considered in network.
NewtoYou
on 4/23/12 12:44 pm
VSG on 09/10/12
Thank you for your response.  When I originally called, I asked about the band, she said " yes weight loss surgery is covered"  and went on with details.   80%, 40 bmi or 35 and co morb... no need for the 6mo check ups, the hospital I will go to is in network.

It's the words " covered for reimbursement"  that I didn't understand.  I will have to call back and get more information until it's more clear to me.  
moonglo82
on 4/23/12 12:35 pm
VSG on 03/29/12
Yep... every plan is different. I also have UHC and my insurance excludes all types of wls. The only way to get any real information about your insurance is through the insurance company or your surgeon's insurance coordinator.

    
Highest weight: 277 Starting Weight: 250  Surgery Weight: 241  Current Weight: 130

Goal Reached in 10.5 months :)


 

NewtoYou
on 4/23/12 12:42 pm
VSG on 09/10/12
I know mine absolutely does cover.  80% of surgical procedures etc.  So far the only thing not covered has been the psychiatrist.  BUT having said that I was originally listed as inquiring about the adjustable band... now I am thinking sleeve after much research.

When I called UHC (please excuse my typo in the subject bar) they said yes, it's covered for reimbursement.     This is not a term I am familiar with.

moonglo82
on 4/23/12 12:44 pm, edited 4/23/12 12:45 am
VSG on 03/29/12
Reimbursement means being paid back for something. Usually that means that you have to pay out of pocket and then they cut you a check for their share. I'm not sure why a procedure would only be eligibile for remibursement, though, unless maybe that dr is out of network

Sounds to me like you need to call back and hope to talk to someone who can clarify a little better.

    
Highest weight: 277 Starting Weight: 250  Surgery Weight: 241  Current Weight: 130

Goal Reached in 10.5 months :)


 

Most Active
Digestive enzymes
zeek70 · 16 replies · 246 views
Recent Topics
Digestive enzymes
zeek70 · 16 replies · 246 views
second puberty yay
thundermuffins · 5 replies · 251 views
9-month Checkup
Kathy S. · 1 replies · 190 views
×