Question:
Questions about how UHC works, in-Network vs. Out-of-Network

   — Lynn W. (posted on November 24, 2002)

November 24, 2002
It is possible and quite common actually for physicians to be in network and the group not, and vice versa. As long as you have your surgeon in net you will be fine. As for your letter of med nec. have your current pcp write one and take it to your new pcp. And does your plan require you to choose a pcp? Alot of uhc policies dont require that anymore.
   — RebeccaP

November 24, 2002
I have UHC and if you do not use doctors that are in network. you will end up paying more for the surgery and not getting all the dicounts that you can for useing all doctors and hospitals in network. As for seeing a doctor for the first time I got a referral from my primary after seeing him for the first time and my dr. who perfromed the op aproved me and wrote the insurance company after my first visit.
   — Tracey H.

November 24, 2002
Hi, thank you for the great information. My plan does not require me to choose a PCP, however, my WLS doctor says to choose one that I plan to be with for a long time to come. My current PCP is with Kaiser, she will not write a letter of medical necessity for me. She believes I need to go through their weight management program and I will be just fine. :( Since posting this I have discovered the three doctors referred to me by the WLS are In-Network, I think I will have a better chance with one of them as they are WLS friendly. Lynn
   — Lynn W.

November 24, 2002
If your plan does not require you to choose a PCP, you will not need a letter of med. nec. from anyone other than your surgeon for UHC. Cant hurt, but not needed. And you will not need a referral to see this surgeon. It is a good idea to have a general doc that you see on a regular basis, one that is open to the WLS idea, so that if you need help later you will have that resourse.
   — RebeccaP

November 25, 2002
Hi Lynn, Just to ease your mind some, if a PCP is being referred to you by the wls surgeon, chances are they are familiar with the procedure and support those wanting the procedure. Jusst because you have never met with the PCP does not mean you will not get a letter. Make an appointment and visit with him/her and express your eagerness to have wls. Also, the surgeon will most-likely have to write a letter as well (at least mine did), so that will help you also. Best wishes and please email me if you have any further questions.
   — Kody O.