State of AZ Employee/United Healthcare?

Is there anyone out there who is a State of Arizona employee having United Healthcare insurance? A friend of mine who is trying to get approved for surgery wanted to know if any other state employees with United Healthcare had been approved this year. Thanks.

State employee here. As far as I know, the state wrote in an exclusion for those covered by United. The only state employee insurance option for coverage was Schaller Anderson last year. Open Enrollment is coming up and I would advise your friend to check with their HR specialist or their insurance liaison to see who might be covering the surgery next year. You might also have them try contacting Dr. Blackstone's office because they are usually pretty knowledgeable about coverage for state employees. Connie

Hi there... Does UHC for the state of Az cover lap band? I was told by my case person in UHC that they will not cover lap band....hmmm. My UHC is UHC Choice,, and she said they cover 80 percent gastric, and nada on the lap band...though I don't want the lap band anyways... Smile.... It does seem the state UHC is different, because Colleen at Dr. Fangs asked me which I have, as though the state covered *less*. -Pondering in Phx.

Linda, I really don't know all the details about which insurance option will cover what procedures. I know that several insurance companies won't cover lapband because they consider it "experimental." You might want to call several surgeons' offices and ask their insurance specialists about your particular insurance. I know that when I was trying to get insurance coverage several years ago, the insurance company was useless about giving me correct information. One of he things that I did was request my benefits coverage book that details exactly what is covered and what is excluded and go from there. I'm sorry that I wasn't too much help and wish you the best. Connie

You all are plenty of help, invaluable even! I do not want the lapband, because I do not want to have adjustments... I suspect UHC Choice does not cover it, because most insurance companies want a "one time" expense... I am now concerned about getting the best care possible,and have asked for feedback on St. Lukes in that vein. God Bless..

For others information....UHC DOES cover Lapband.....I understand that you have chosen the Rny but others may wonder. As for the adjustments (aka as Fills) .....Insurance does not project a predetermination in regard to these. If they are done udner fluroscopy at a hospital then they are covered. If they are done at the doctor's office then it is at the discretion of the surgeon. Usually a co-pay is all that is paid. St Luke's is an older hospital in a questionable part of town. BUT...their BARIATRIC staff is wonderful!!!! They would NOT have qualified as a Center of Excellence if they were not clean, efficient and completely safe! .... If you are concerned at all then ask Kelly (director of Bariatrics) for a tour of the Bariatric floor. And, while in there, if anything at all is of concern then you can send the word up to her and she rsepond asap!!!! .....My DH had a fuzzy t.v. and one call up to Kelly and they were installing a brand new one within the half hour!!!!! Many many many have had different types of experiences at all hospitals. Take the reviews on this site with a huge grain of salt. Often those who have had a Disneyland experience are just home living their lives and don't share reviews. For some reason...those of us who have been ticked off or had a bad experience want to make darn sure that everyone else knows about it. I commend you for doing research but going to the source is often the best deal..... Good luck, Joyce

Thanks for your response, I appreciate it. It would seem there are a lot of variations to UHC. Mines DOES NOT cover it as stated in writting to me about 6 weeks ago...thats why I was asking if the state was different. You are very kind, I am sorry you lost your friend to wls... We lost our center manager recently, and approximately 2 years ago, a church member. It is a bit scary, but I know the danger I live with at this weight. God bless

Thanks once again for your response... I have toured the hospital, and did have the pleasure of meeting Kelly, Dr. Maxwell, Dr. Fang and a host of other staff. For me, the source and feedback I wanted is RIGHT HERE. I guess we all do things our OWN way. Thanks once again, God be with you, Linda

I cannot comment specifically on United Healthcare, but I'm suspecting that since the State is self-insured, the State has written the prior authorization criteria that all the health plan choices must follow. I know Schaller Anderson is doing the prior authorization for my plan, even though I have Arizona Foundation not Schaller Anderson. Don't know if they do it for all plans or just some? Check my profile for the hassle I went through just to get a copy if the prior auth criteria. There is no exclusion for the lapband by the way in case anyone is interested in that. It can't be considered "experimental" - though I know some companies try to get away with that excuse - because it was approved by the FDA in 2001 and by Medicare in February of this year. I have not yet met the requirement for the 6 mo doc supervised diet, so don't know yet what my odds of getting approved are....with heart disease and most of the other co-morbidities except diabetes, for which I have a strong family history, if they don't approve me the odds are they won't approve anyone (in which case we ought to get together and sue the state