Georgia State Employees - United Healthcare Choice

Anyone out there with this plan who go approval for the surgery? I was told they don't cover it. Thanks.

Hi Rhonda, how are you? I work for the local school district here in Columbus. I have Cigna HMO which is a pain. I first had state merit insurance they said no way no how will they cover. I then switched to Cigna who assured me that they covered with the necessary requirements, nutri eval, pysch eval, etc. Well now we sent off for approval and they are saying they are not covering in 2005. Well my point is that my coverage runs from July 1, 2004 through June 30, 2005 and is still in the same year. Also, no one ever sent me anything stating changes. Well they said no way it did not matter. Well then state health said it was clearly listed in the bylaws. I got a copy of the summary of benefits and it says that the PPO, PPO choice, and Indemnity plans will not cover gastric bypass. Okay I already knew that that is why i switched to Cigna. Well in the summary of benefits it says for HMOs to see the Health Plan Decision Guide. Well I did and no where does it say that the HMO will not cover this procedure. If they were not going to cover why have they paid for everything needed for the requirements and the surgeons consults. Also in the summary of benefits it says that you will be notified in writing of ANY changes. Let me tell you from the getgo document everything. I see that this may end up being a legal matter. Good Luck to you. Thanks, nalani

UHC doesn't cover it. I had a friend (sarah) that was denied because of an exclusion. I have BCBS HMO with the state, but from what I've heard they will not be covering it effective in June. Amy

Ugh. Well I'm still in the deciding phase. The funny thing is that I just switched from my husband's plan in November. I can always switch back to my husband's plan at his job after our open enrollment and pursue it from there. In the meantime I can do the supervised diet and any other steps prior to. God is sovereign. If it's meant to be it will be. Thanks.

Blue Choice HMO won't be covering as many due to some people who are having the surgery for vanity reasons as opposed to health reasons. They are going to be much more selective than they have been in the past. Don't worry...it will be great! Just keep on them abou the necessity of having the surgery. ~Nicole