Question:
Considering United Healthcare PPO (Fort Worth, TX)
After fighting with CIGNA for a year, my husband has the option of selecting UHC PPO in November. I know that in years Past UHC has been very supportive of WLS. Is that still the case. Has anyone out there been approved since 9/1/03? You can email me directly, if you'd prefer at [email protected]. Thank you. — Karen P. (posted on October 26, 2003)
October 26, 2003
My husband has UHC EPO, I was approved in 3 weeks, but every policy is
different. I would call and see what they say, you don't have to tell them
who you are. Just ask if they cover Gastric Bypass for Morbidly Obese
People.
Some employers don't have it in their policys!
GOOD LUCK!
— Saxbyd
October 27, 2003
Karen, take a look in the library. There has been quite a bit of
information about this plan on the AMOS website.
— M B.
October 27, 2003
Normally, PPO's cover a little better, however, that doesn't mean that this
particular employer has chosen to cover the surgery. Every employer who
offers UHC PPO as insurance can somewhat pick and choose what they want the
policy to cover. To be sure you are getting what you want, you need to
contact the employers Human Resources department and ask for a copy of
their open enrollment information which should detail exactly what is
excluded.
Good Luck.
Carolyn
— Carolyn M.
October 27, 2003
IF WLS is covered under the plan it is very easy to obtain approval.
However, if there is an exclusion, there is almost no chance to gain
approval. Every plan is different within UHC. It is specific to the
employer, and each employer may have differnt UHC plans some covering the
surgery some not. Luck of the draw basically. Ask to see the UHC policy
that his company is offering, so that you can make a better informed
decision. This shouldnt be difficult or even unusual seeing that it is the
same company. --Becky
— RebeccaP
October 27, 2003
I don't know about United, but I recently got approval about a week and a
half after the first letter through the Texas High Risk Health Insurance
Pool. Surgery for morbid obesity is a guaranteed provided benefit! Good
Luck!
— Michael S.
October 27, 2003
My husband has UHC through General Electric and I was approved after 4
weeks. My surgery date was 6/24/03. As far as I know they cover it. Call
them directly or they have a website myuhc.com. Hope this helps!
— Danna S.
October 27, 2003
I have UHC. I got approved in Sept. for surgery November 11, 2003. Our
policy covers this surgery 100% now...however, next year it won't be
covered 100% only 80%. You may want to look into this.
— Renee B.
October 27, 2003
all uhc ppo policies vary per employer, my husband has uhc ppo and it has
a written exclusion whether medically necessary or not. good luck and make
sure you read the policy carefully
— PATRICE T.
October 28, 2003
We have UHC PPO (Carthage, TX) with no exclusion and no problems getting
approved. My BMI was 37.9 so I was a little nervous but they did approve
after about 2 weeks.
— Julie S.
October 29, 2003
Thank you for your resposes. I am now pestering my husband's benefits rep.
for paper copies of policies and exclusions.
— Karen P.
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