Unicare PPO what have you heard about them?

Unicare PPO? Has anyone heard about them? Do they have a bad reputation for approving surgery? We called them and it is covered in my husbands plan. Any info would be appreciated.

Miss K: I had UniCare PPO last year. They have two levels of plans. If your husband's company is considered a "Large Group", you should have no problems. While dealing with them, they even told me that several of their employees have had this surgery covered, but they are a "Large Group". My company is a "Small Group" (8 people) and they exclude WLS coverage from ALL "Small Group" policies. I believe a "small group" is defined by less than 50 employees, but it may be 25. I fought them all the way to the Attorney General's office, and the Dept. of Insurance, to ultimately be told that UniCare is not breaking any laws, nor are they discriminating by not offering the coverage to a "Small Group". If you are interested in the details, they are in my profile. Good luck to you, and congratulations on your success so far. Dawn

Thanks Dawn...I'm confused I'm pretty sure my husband has a "small group" but when he called them up they said it was covered under his plan??? I'm wondering if the person he was talking to made a mistake. I hope this is not the case. Thanks for your help, I'm going to double check now.

I'm pretty certain it depends on what type of policy his employer is signed up for, not the size of his company. If the policy says it is covered, then it is. I was covered by Unicare previously with a larger company, but my employer's policy excluded WLS. I was approved by my current employer's policy...which, by the way, is not Unicare. Best of luck to you. Jeff

Hi Miss K J. I have Unicare PPO, and have just now approached them to cover the surgery. When I called them, I got someone that could hardly speak English, but I understood enough for him to say it is NOT covered. I then called Dr. F office and they had just spoken with someone as well, and got the same comment, BUT when they were told the code of the surgery to put in, it came up covered! I pray this is the case. I will know more soon I hope. Hang in there, and keep trying! Rebecca S.

hi Miss K J, i also had Unicare PPO and my husbands employer has about 10 employees at the most and his insurance covered my surgery. I believe I had surgery jan. 19, 2004, i always get confused with the year. Dr. alverdy at UofC performed my surgery and he is a wonderful surgeon. Don't give up, it took me like 2 years to get approved but it was my fault because I didn't try hard enough at first, you have to bug the hell out of your insurance company and don't take no for an answer. Just keep trying. Good Luck !!!! Chicago