Question:
UHC PPO - Has anyone had any luck with their employer overturning an exclusion?

I have United Health Care PPO and when I started this journey I called them and spoke with a rep and asked him specifically was the exclusion on the part of my employer or was it on UHC. He said that it was not my employers exclusion. Never again listen to them. So I proceeded to go on with all of this and 6 months later today I got a phone call from the Dr office saying that I was denied coverage because the exclusion was my employers. I am going through the proper channels to try to get this overturned but I was wondering if anyone had any luck in getting this done. Any feedback would be greatly appreciated:( jeannie    — harleigh2002 (posted on June 4, 2003)

June 4, 2003
Jeannie, I am having the same exact problems. I had my consult on June 25th and had to cancel it. I spoke with the gal that does the insurance for the doctor I want to use and she said that UHC's exclusion is impossible to overturn. Since my company is self-insured I am told that they decide on the exclusion. Of course, my HR department says it is UHC and not them. But, I am not giving up. I have been collecting information on others with UHC that have had the surgery and want to present this to my HR department. I also want to ask for them to override the exclusion. Try asking your company to override your exclusion. I have read where a few people approached their employers and got approval. I say it never hurts to ask. I hope it works for you. Terry
   — Terry Lynn W.

June 4, 2003
Jeannie, I too, was going to enroll in UHC PPO, but I talked to a surgeon and he advised to go with UHC POS. Less hassle. I know this may not be much help. But just in case you do not get approved, you will know of a alternative.
   — Latisha A.