Did United Healthcare Cover Your Plastics?

Hi - if you have United Healthcare Insurance, what was your experience in getting them to cover your plastic surgery? Were you successful or not, and why? Thanks a bunch! I am submitting my claims  after the fact and hope to get reimbursement. Thank you for your replies!

Hi,

I have United Healthcare ( Oxford Freedom) and they paid for my TT and breast lift/reduction. It should not be exclusion from your policy for any reconstructive work.

I saw chiropractor for 6 month for treatment of my back and also I lost more then 100 lb( 200 actually) and my panni was handing way below that required.

I did not show any pictures with rushes but my doctor put them in notice every time I saw him.

And i got denial first time for both surgeries; appealed and won!

Good luck and fight!

Good for you!!! I was on tramadol for years with back pain and went to several specialists for my back. Nothing worked except getting the excess skin removed. Unfortuantely, I do not recall the physicians' names or even what insurance I had at the time. So if the insurance asks for proof then I maybe out of luck.

I had a healthcare spending account with $2k in it that was towards my surgery. But my lovely employer let me go about 3 weeks before my surgery and so the insurance company will not give me the $2k. I appealed and they denied my appeal. They said I could appeal again but I said to hell with it.

Hopefully I can get some reimbursement from the medical insurance plan. It was a good plan.

Nope and I went through 3 appeals, apparently because I had WLS and had babies my life was worth less than if I had not. If I had not had WLS or babies then I could justify how the skin affected my everyday life. I also did not have any transdermal ulcers. I had 4 doctors, Surgeon, Dermatologist, my PCP, and bariatric surgeon write letters stating the medical necessity. My extra skin was pulling my lap band port causing sever pain due to scar tissue build up.Everytime I bent over it felt like I had an ulcer.

Good luck

Wow, that is bad! I hate insurance companies. I once turned down a very good job offer with United Healthcare because I hate them so much (and because I had another job offer).

It all depends on the riders that your company has purchased. You can't go by what others who have the same insurance as you as they may have different riders purchased that may include or exclude coverage. As you can see one person who has UHC got theirs covered and another one didn't. I have read my insurance coverage riders and it specifically excludes any type of reconstructive surgery unless for breast reconstruction due to a mastectomy. It even goes to the point that it specifies that under no cir****tances will it be covered even due to extreme weightloss due to surgery bariatric surgery. The best source of information on weather yours may be covered is to read your companies insurance policy.

I do not work at that company any longer so I do not have access to that sort of information. I also dropped the insurance recently because the COBRA payments were killing me. I guess that I can phone them and see what the coverage is. 

Does your policy allow for them, period? They were specifically excluded from the UHC policy I had except in cases of oncology reconstruction. 

I don't know and do not have access to that information. I am going to phone them in the morning and ask. 

I have United and they just approved the breast reduction and my plastic surgeon is putting in for the TT.   I hope to have it done before the end of February.