Guest guest Posted July 28, 2004 Report Share Posted July 28, 2004 Anyone here got their surgery approved through United Healthcare? One of the surgeons I had a consultation with said that United has a strict exclusion about orthognathic surgery and didn't even want to try to get it approved through them. I'm going to get a second opinion from a different surgeon. If not I'll probably switch to Kaiser of Definity for next year. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2004 Report Share Posted July 28, 2004 I have United Healthcare Select Plus POS and it approved my surgery (move the lower jaw forward) without any problem. I had my surgery 6 weeks ago today and UHC has already paid the hospital and the actual surgeons bills are pending the surgery notes to be sent. > Anyone here got their surgery approved through United Healthcare? > One of the surgeons I had a consultation with said that United has a > strict exclusion about orthognathic surgery and didn't even want to > try to get it approved through them. I'm going to get a second > opinion from a different surgeon. If not I'll probably switch to > Kaiser of Definity for next year. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 29, 2004 Report Share Posted July 29, 2004 I have United Healthcare and they denied my surgery. I appealed twice and still got denied. I am going to a different OS too next week to see if he can help me get it approved. Good luck with UHC. > Anyone here got their surgery approved through United Healthcare? > One of the surgeons I had a consultation with said that United has a > strict exclusion about orthognathic surgery and didn't even want to > try to get it approved through them. I'm going to get a second > opinion from a different surgeon. If not I'll probably switch to > Kaiser of Definity for next year. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 29, 2004 Report Share Posted July 29, 2004 Thanks, That helps alot. I just need my lower jaw moved forward as well. Hopefully I will have the same experience with you because I really don't want to switch insurance. > > Anyone here got their surgery approved through United Healthcare? > > One of the surgeons I had a consultation with said that United has > a > > strict exclusion about orthognathic surgery and didn't even want > to > > try to get it approved through them. I'm going to get a second > > opinion from a different surgeon. If not I'll probably switch to > > Kaiser of Definity for next year. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 29, 2004 Report Share Posted July 29, 2004 Wow, it amazes me that insurance companies can pick and choose who they approve. Its just crazy. What state are you in because someone said that it varies by state. Good luck with getting it approved. > > Anyone here got their surgery approved through United Healthcare? > > One of the surgeons I had a consultation with said that United has > a > > strict exclusion about orthognathic surgery and didn't even want to > > try to get it approved through them. I'm going to get a second > > opinion from a different surgeon. If not I'll probably switch to > > Kaiser of Definity for next year. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 29, 2004 Report Share Posted July 29, 2004 Hi, I have United Healthcare Choice. After losing my paperwork twice, I received a letter saying that " We have completed our review of your request for coverage of Orthognathic surgery, and we're pleased to inform you that coverage is available " . I doubt they were pleased, though... :-) I'm hopefully going to have my surgery mid-August. Hopefully they won't change their minds -- but I have their letter saying they would cover it.. so.... Good luck! -Blake > > Anyone here got their surgery approved through United Healthcare? > > One of the surgeons I had a consultation with said that United has > a > > strict exclusion about orthognathic surgery and didn't even want to > > try to get it approved through them. I'm going to get a second > > opinion from a different surgeon. If not I'll probably switch to > > Kaiser of Definity for next year. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 29, 2004 Report Share Posted July 29, 2004 I am in Virginia. My health insurance is a self-funded plan, which means that United Healthcare administers the plan but my firm pays the claims out of their money, not United Healthcare's. So this means that if I didn't have a self-funded plan and United Healthcare paid the claims, there is a statute that says that health care providers cannot deny surgery for the face, neck or jaw when they cover surgery for other bone or joint surgeries. You should take a look at your plan to see if it's a self-funded plan (your HR person will know this and make sure you bug them until they tell you). This should also be in the Summary Plan Description that your company has. Ask for that too. They HAVE to give it to you when you request it. If it's not a self-funded plan, then you may this state statute to help you. What state are you in? I know VA, NC and FL has this statute. This is worth looking into. > > > Anyone here got their surgery approved through United > Healthcare? > > > One of the surgeons I had a consultation with said that United > has > > a > > > strict exclusion about orthognathic surgery and didn't even want > to > > > try to get it approved through them. I'm going to get a second > > > opinion from a different surgeon. If not I'll probably switch to > > > Kaiser of Definity for next year. Quote Link to comment Share on other sites More sharing options...
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