Coverage with United Health Care - please help!

Thundergrrrl
on 8/16/11 9:20 pm
Has anyone gotten any portion of their PS covered by United Health Care? I have a pretty decent insurance plan, it covered 100% of my lap band, and now I am planning on a TT and realized the annoying sores and rash I have under my extra skin may help me get some of this covered.

If anyone has had success can you please tell me what you did or how you started? UHC customer service is nearly always a frustrating and impossible experience and I can't get someone on the phone who knows what they're talking about.

Thank you!!

Highest Wt: 274 / LAP-Band Low: 180 / Sleeved at 233 / Goal: 160!

Jujuvee
on 8/16/11 9:53 pm
You should be able to go to there online site and type in you numbers and it will bring up your plan. I have United Health but no cosmetic coverage. So it's self pay for me!

Good luck.

HW 405- Pre op weight 374- Plastics weight 203 Current weight 194

Circumferential lift/Brachioplasty November 8, 2011

16.3 pounds removed.

Revisions + Thighplasty  October 23, 2012

Breast lift- Spring 2013
 

fatoldbat
on 8/16/11 10:18 pm
i also have united health care....and i'm self pay.  my plastics are not covered.
Blessings,  J
HW 250.4/SW 238/1ST GOAL 155/2ND GOAL 150/CW 143.6
    LW-Apple-Gold-Small.jpg image by PlicketyCat
alla B.
on 8/17/11 12:47 am

I have UHC and they paid $10K for my TT from $12K my doctor chatged.

It was a miracle! I went to chiropractor for 5 month treatments 3 times a week and documented rush under skin with my PCP. I was denied 2 times and approved only with external appeal.
I was very lucky.
Now I got approval for my BR/BL as well based on the same chiropractor treatments for back and neck pain for 12 month and rushes under breasts.I did mammogramm, they are required it.

I got 1 denial, then was approved after PS( new one, not that who did TT) did per peer review.
Good luck,
Alla

PART 1 VSG  03/28/2006;  PART 2   DS  01/31/20007

JodiLee1
on 8/17/11 11:18 am

I have 2 insurances.  My Primary NGS paid for the panni only.  UHC's denial letter regarding the panni and TT was rude.  They said it was not necessary and cosmetic only.  I paid for the add on for the Fleur de li (full TT) to add to the panni, lipo, breast lift and implants.  I didn't expect insurance to pay for the breasts or lipo.  Every plan is different.  I had rash, photo and physician documentation.  My pannus hung onto my thighs.
But, I was determined no matter what I was getting it all done at once and I'm so glad I did.

                    
Thundergrrrl
on 8/18/11 7:33 am
I found a document online for UHC that gives the criteria for getting pani or TT covered as "reconstructive" and they make it nearly impossible for anyone to qualify.

You have to have an eval by a physical therapist and not be able to walk 50 feet due to the extra skin. I am fortunate to be nowhere near that bad. I don't even have a "pani that extends beyond the pubis" which is the first requirement.

Oh well...guess I'll be self pay.

Highest Wt: 274 / LAP-Band Low: 180 / Sleeved at 233 / Goal: 160!

Most Active
×