United Health Care? Revision Coverage?
Has anyone in California gotten an approval for a revision from United Health Care? I just met with a surgeon yesterday and he has agreed to do my revision. Now I'm just waiting for my psch evaluation then his office will put in for my insurance approval. I'm not to sure what to expect with UHC. My original surgery was covered 100% from HealthNet. So, anyone who has dealt with UHC I would love to hear about your experince with them. Thanks!
Hi there,
UHC paid for my original surgery 100% back in 2002, so I would think you should be good. I do know that they changed their policies to reflect having to have more documentation, counseling and background information that is documented by a physician. Also - make sure you check with your particular policy as some companies will have exclusions in place, regardless of the insurance company. UHC might pay for me with Company A - but not for you with Company B, if that makes sense.
Give them a call - it definately doesn't hurt to ask!
Heather
UHC paid for my original surgery 100% back in 2002, so I would think you should be good. I do know that they changed their policies to reflect having to have more documentation, counseling and background information that is documented by a physician. Also - make sure you check with your particular policy as some companies will have exclusions in place, regardless of the insurance company. UHC might pay for me with Company A - but not for you with Company B, if that makes sense.
Give them a call - it definately doesn't hurt to ask!
Heather
UHC paid for my original surgery in 2003 and have denied my revision and my appeal of their denial. They are citing a stoopid patient selection criteria rule that you have to have a BMI of 40 or more for the past 5 years. Hello, idiots! I had surgery in 2003 and lost 100lbs and then the damn band slipped - of course I'm going to have been under BMI 40. I'm quite po'd!!!
I'm continuing the appeal process with my advocates (obesitylaw.com) but will not actually get UHC to pay for my surgery as even if we get them to reverse their decision this month my surgeon won't be able to do my revision in December.
I've chosen another insurance carrier for my company-provided insurance for next year. Here's hoping they don't even think of denying me.
I'm continuing the appeal process with my advocates (obesitylaw.com) but will not actually get UHC to pay for my surgery as even if we get them to reverse their decision this month my surgeon won't be able to do my revision in December.
I've chosen another insurance carrier for my company-provided insurance for next year. Here's hoping they don't even think of denying me.
I got UHC for the State of Arizona to pay for my revision. I did have to have the BMI of 40, which once I hit that they didn't have a chance. I also had a mechanical failure, so it was going to have to be fixed sooner or later by what he found when he did the revision surgery.
They really don't have criteria for revisions.
They want you to qualify just like a newbie. I hire Walter and Kelley and I won my appeal against them. Don't hesitate to hire them.
Show them your weigh in's if you have them, your testing results, anything you can give them. Write your own letter to them, get one from your PCP. Don't mince words with them. Lay it all out there if you have to appeal. List all of your co-morbidities, you will have to have those. Psych eval, nutrition counseling, food journals, weight ins, behavioral modification. They will also try to push the 6 month supervised diet upon you again.
UHC won't give you any information over the phone. You will have to submit and go from there. Just get your ducks in a row before you submit.
Just be prepared for them to deny you right off the bat, but don't let them win.
They really don't have criteria for revisions.
They want you to qualify just like a newbie. I hire Walter and Kelley and I won my appeal against them. Don't hesitate to hire them.
Show them your weigh in's if you have them, your testing results, anything you can give them. Write your own letter to them, get one from your PCP. Don't mince words with them. Lay it all out there if you have to appeal. List all of your co-morbidities, you will have to have those. Psych eval, nutrition counseling, food journals, weight ins, behavioral modification. They will also try to push the 6 month supervised diet upon you again.
UHC won't give you any information over the phone. You will have to submit and go from there. Just get your ducks in a row before you submit.
Just be prepared for them to deny you right off the bat, but don't let them win.
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