UHC and Plastic Surgery

Ashley S.
on 8/25/04 9:09 am - Anywhere, US
Just wondering if anyone got their skin cut and tucked under UHC. I will be talking with them next year, and wanted to know. If they're as pissy about it as they are about the WLS surgery, then I want to start looking for another insurance to pay on for that momentous day. JB
Roberta A.
on 8/26/04 8:18 am - Marietta, GA
Read your Summary Plan Description to see if Reconstructive Surgery is covered. Then write UHC and ask them for their Utilization Review Guidelines. My Plan has Reconstructive surgery as a total exclusion, unless it's to correct a congenital deformity, or for breast surgery after mastectomy. I writing an appeal for someone else who's Plan will pay for R.S. only to correct a "functional impairment." They did not want to see pictures and they do not follow the guidelines set by the American Association of Plastic and Reconstructive Surgeons for r.s. after WLS. Both of us have UHC as the claims administrator. Believe it or not, Cigna is going by the guidelines for reconstructive surgery, even though they are a pain in the patootie when it comes to WLS. Still, every plan is different, so read your Summary Plan Description carefully. From what I've been told, the majority of us end up paying for r.s. out of pocket. Bummer. (I still plan on giving UHC my best fight first.) Yours in hanging skin, Roberta
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