Which Insurance is Better?

 Dear Members,

I am currently having to re-up my insurance and pick a provider. I am looking into getting surgery next year. I would like to know from others experiences if United Healthcare or BCBSNC are better to work with for approvals?

Many Thanks,
Jennifer M.

Hi Jennifer,

It's nice to meet you. I had United HealthCare and so does my husband and we have found them to fine to work with. Generally, they seem to take a little bit longer to give you an answer, but other than that, it seems that they are both fine. You might try cross posting this question to the main forum, the insurance forum and the surgery type forums for the surgeries you are interested in. You might also check with your HR to see if they have any exclusions for WLS. I know that my husband's company covers it this year, but will stop covering it Jan 2009. Usually, when there are two companies providing coverage, they often have mirror coverage, meaning that it's the same. However, you might want to find out who their 'contracted' providers are. They may be same, but they might vary and if there is a surgeon, program or hospital you are particularly interested in using it might be worth checking to see if they are on either of the insurers list of preferred providers.

Wishing you all the best,

Barb

I had BCBS State Employees and I was approved within one day.  It always doesn't depend on the insurance though, sometimes its the surgeons insurance person.  Best of luck to you!

Nancy

I had UHC last year when I first started my WLS journey. I had all of my pre op tests done...which they paid for...just to be told when we filed for approval3 months later that there was an exclusion in our policy that didn't cover WLS for any reason, even with documentation of medical necessity...ehich I also had.
All depends on your ploicy.
Look into it. Be thorough. Ask lots of questions.
Good luck!

Mare

Mare - you look great.

I had BCBS State Employees and I was approved within 24 hours.  It only took 2 months from the time I started my preop testing, etc. til my surgery date.  I have no complaints whatsoever with BCBS.  I also have had no problems with any follow up visits.

Well

My family has had a bad experience with United Health Care. First a lot of primary care physicians do not take United Healthcare. They generally do not cover some procedures that physicians order. And they are very strict with medications. My father is on a very common blood pressure medicine and they will not cover it so the doctor had to switch and put him on 2 medications that = 1.

What I recommend is going to United Healthcare and look at your plan to see in general what they cover.

Common procedures that you would not think would be hard to get covered is. I recently was at the Sleep Center where I have my CPAP and they are no longer in network.

They do not have a lot of "in network" practices which makes them able to pay 60% or less on procedures.

I would also look to see what restrictions your United Healthcare has with weight loss surgery. I know someone that they changed to United healthcare and they did not cover the surgery.

Each insurance company has a contract with your employer and can put whatever restrictions they want on the insurance plan.

Tamara

Deaar Members,

Thank you all for your replys. I am going to be making some more phone calls per your comments and find out more about the exclusions. They do not make it very easy to find this info. they only want to provide the basic summaries of the plans. Guess I'll be busy tomorrow.

Thank you all again,
Jennifer M.
Willow Spring ,NC

P.S. Any other experiences or comments are greatly appreciated!

I would start by finding out if either plan covers WLS - one may and one may not which would make your decision easy. Not sure what BCBS current requirements for WLS are but when I had surgery over 2 years ago they were one of the few that did NOT require the 6 month supervised diet, I believe UHC does.

Unfortunately, I had to delete this post due to privacy concerns.

Thanks Everyone,

Found out both policies cover WLS as long as it is medically necessary. So, I have decided to keep my existing UHC since they sure enough now about all existing problems anyway. Going to go to the seminar at Wake Med. Thursday and hope to be on my way to enjoying life on the other side soon. Thank  you all very much for the information.

God Bless,
Jennifer M.