First letters to UHC - Wish me Luck!

Well, I put the letters and all my back up letters and information in the mail this morning to United Healtcare.  Asking for pre-approval for the exclusion on my health coverage.  I'm not very hopeful, maybe it's a defense mechanism, to get get excited, so as to not be so dissapointed, oh well.

What I did find out through my initial research, is that it wasn't my company's decision to exclude it from the benefits covered, it was in fact UHC's decision for our company. My CFO did go to bat, sending emails, inquiring, etc.  Short of changing insurance companies, I dont' think there was more he could do, so this is my next step.

Fingers crossed......... oh hell..... everything crossed!!!


Red

From personal experience I will tell you that the ONLY one able to lift the exclusion is your employer!! UHC will reject.  My surgury was not covered by my medical. I only found out 6 months AFTER surgury. I have BC-MA and BC-RI approved it and surgury was completed. I have written so many letters to so many different companies & lawyers and have come up with so many denials. FINALLY I was notified that if and only if my company would make an exception to lift the exclusion then and only then would my medical cover the expenses. Well that has not happened to date and I am paying Dr Roye $50.00 /month untill all my balance to him is paid. The hospital has not bothered me..I'm ssure they will garnish my paycheck at soem point.
GOOD LUCK and go to who ever writes up the meidcal palns in your company and they will have to find a way to lift the exclusion!!

Jaime

Best of luck Red! I have my fingers & toes crossed for you too..hopefully you'll be surprised and get a good news letter but I know how you feel being on the defensive side of it. I was that way too...Aetna required that I do 6 months up front of dietician counseling and it seemed like it took forever..along with a lot of other invasive testing that they required but it finally worked in my favor. Keep up the fight!!!!
My date is quickly approaching and I'll check back once I'm home from the hospital to check back to see how you made out.
BEST OF LUCK!!! 

My experience in 2008 with UHC was a bit different from what Jaime wrote.  I ended up speaking with a higher up in the office in Warwick after I was told I wasn't covered.  He told me that UHC considered the band experimental, and no matter what I wrote or submitted, they would not cover it.

Don't want to rain on your parade, but I don't want you to get overly excited, either, in case things just don't pan out for you.

I hope you do not take me as being Debbie Downer, but I used to be in underwriting at a major insurance company, and if there's an exclusion, it doesn't matter how many letters you have, you won't be covered under that policy.
You could have lung cancer & if the company says "we will not cover lung cancer treatments" then you wouldn't be covered for that either.
The policy can be changed, it has to be done so by your employer, and usually only at Open Enrollment, when changes to the policy are made on an annual basis.
Your company would have signed off on the recommendations made by UHC based on how much they wanted to pay per employee, or as a whole for the policy. Certain companies exclude coverage for certain conditions as a cost-saving measure. Believe me, as much as you want to blame UHC as the big bad insurance company, ultimately it was your company that decided not to cover the procedure.