Insurance Approval (UHC) Please read and comment!!!

[Guest guest]

Hi Gail:

Do you know what type of plan you have? Mine is UHC Choice Plus and in my

certificate of coverage book I found the following: under General Exclusions:

Food supplements, vitamins, obesity therapy, any diet or exercise program or any

other form or method of weight control by surgery, including complications of

such surgery, program or method. Is there something I can possibly to in order

for them to cover. My family MD is also my boss, and he is willing to do

anything in order for me to have this surgery. Has anyone had experience where

their insurance provider would not cover but were able to overturn it? Please

give me all the info anyone can.

Thanks

Re: Insurance Approval (United Health Care)

Hi, Amy

I had united healthcare when I had my surgery (5/29/00) and they paid for it.

What I did is called them myself and asked if they covered WLS before I

started my packet. I think when it was all over I paid like $300.00 maybe a

little more. Good Luck

Gail in Chapel Hill, NC

down 90 pounds

[Guest guest]

Amy,

I have the same " problem " with my insurance, AmeriBens (ABS) our coverage

book states the same as yours. If you get any helpful info with regards to

getting around this I would appreciate hearing about it. I just got my

insurance letter from Dr R yesterday, but don't know how to approach sending

it into the insurance company when the plans states it is not covering

anything to do with obesity and weight loss.

Thanks

Cathy

>

>Reply-To: MiniGastricBypass (AT) egroups (DOT) com

>To: <MiniGastricBypass (AT) egroups (DOT) com>

>Subject: Insurance Approval (UHC) Please read and

>comment!!!

>Date: Sat, 9 Dec 2000 16:49:10 -0500

>

>Hi Gail:

>

>Do you know what type of plan you have? Mine is UHC Choice Plus and in my

>certificate of coverage book I found the following: under General

>Exclusions: Food supplements, vitamins, obesity therapy, any diet or

>exercise program or any other form or method of weight control by surgery,

>including complications of such surgery, program or method. Is there

>something I can possibly to in order for them to cover. My family MD is

>also my boss, and he is willing to do anything in order for me to have this

>surgery. Has anyone had experience where their insurance provider would

>not cover but were able to overturn it? Please give me all the info anyone

>can.

>Thanks

>

>

> Re: Insurance Approval (United Health Care)

>

>

>Hi, Amy

>I had united healthcare when I had my surgery (5/29/00) and they paid for

>it.

>What I did is called them myself and asked if they covered WLS before I

>started my packet. I think when it was all over I paid like $300.00 maybe a

>little more. Good Luck

>

>Gail in Chapel Hill, NC

>down 90 pounds

>

>

>

[Guest guest]

Amy

I have the same exclusions only it says no gastric bypass etc. surgery so I

sent an appeal letter to them last week.. I don't know yet if it will work

I have to give them about another week(technically they have 30 days) but I

will send you the letter if you like.

Battling the insurance trolls

Suzanne

Palm Coast

[Guest guest]

Amy

ps I am using that fact that it is medically necessary. suzanne

[Guest guest]

cathy

I have the same problem I am trying to get in thru on medical

necessity.. I just sent off my appeal last week. I will call them soon.

I do not know if it will work.. i think it depends on who you get to read the

thing..I will be gald to send you my letter tho.. I still may be self-pay.

Suzanne

Palm Coast

Waitng for dancing date

[Guest guest]

Hi I will have UHC as of jan first and I called them to see if they cover

it and they told me they cover 90 percent of the bill and I would have to pay

10 percent. Not sure if you are on the same plan or not but you might want

to go ahead and give them a call. It definitely wouldn't hurt. Terri in

Louisburg

[Guest guest]

Hi I will have UHC as of jan first and I called them to see if they cover

it and they told me they cover 90 percent of the bill and I would have to pay

10 percent. Not sure if you are on the same plan or not but you might want

to go ahead and give them a call. It definitely wouldn't hurt. Terri in

Louisburg

[Guest guest]

Terri,

That is wonderful, 90 percent..... wow, wow, wow, mine covers 80, better

than 70 I guess!!!

Good luck,

sbb

On Mon, 11 Dec 2000 02:26:10 EST alfapak@... writes:

> Hi I will have UHC as of jan first and I called them to see if

> they cover

> it and they told me they cover 90 percent of the bill and I would

> have to pay

> 10 percent. Not sure if you are on the same plan or not but you

> might want

> to go ahead and give them a call. It definitely wouldn't hurt.

> Terri in

> Louisburg

>

>

>

[Guest guest]

Terri,

That is wonderful, 90 percent..... wow, wow, wow, mine covers 80, better

than 70 I guess!!!

Good luck,

sbb

On Mon, 11 Dec 2000 02:26:10 EST alfapak@... writes:

> Hi I will have UHC as of jan first and I called them to see if

> they cover

> it and they told me they cover 90 percent of the bill and I would

> have to pay

> 10 percent. Not sure if you are on the same plan or not but you

> might want

> to go ahead and give them a call. It definitely wouldn't hurt.

> Terri in

> Louisburg

>

>

>

[Guest guest]

I don't have UHC now and I can't remember what one I had.....sorry.

[Guest guest]

I don't have UHC now and I can't remember what one I had.....sorry.

[Guest guest]

Suzanne,

Thanks for replying. As I said I have hesitated to send the letter as am

sure the answer will be no. I would really appreciate hearing what steps

you took to appeal and if you are willing to share your letter.

Thanks for your time.

Good Luck!

Cathy

>From: Claydancr7@...

>Reply-To: MiniGastricBypass (AT) egroups (DOT) com

>To: MiniGastricBypass (AT) egroups (DOT) com

>Subject: Re: Insurance Approval (UHC) Please read and

>comment!!!

>Date: Mon, 11 Dec 2000 00:24:50 EST

>

>

>

>cathy

>

>I have the same problem I am trying to get in thru on medical

>necessity.. I just sent off my appeal last week. I will call them soon.

>I do not know if it will work.. i think it depends on who you get to read

>the

>thing..I will be gald to send you my letter tho.. I still may be self-pay.

>

>Suzanne

>Palm Coast

>Waitng for dancing date

>

>

[Guest guest]

Suzanne,

Thanks for replying. As I said I have hesitated to send the letter as am

sure the answer will be no. I would really appreciate hearing what steps

you took to appeal and if you are willing to share your letter.

Thanks for your time.

Good Luck!

Cathy

>From: Claydancr7@...

>Reply-To: MiniGastricBypass (AT) egroups (DOT) com

>To: MiniGastricBypass (AT) egroups (DOT) com

>Subject: Re: Insurance Approval (UHC) Please read and

>comment!!!

>Date: Mon, 11 Dec 2000 00:24:50 EST

>

>

>

>cathy

>

>I have the same problem I am trying to get in thru on medical

>necessity.. I just sent off my appeal last week. I will call them soon.

>I do not know if it will work.. i think it depends on who you get to read

>the

>thing..I will be gald to send you my letter tho.. I still may be self-pay.

>

>Suzanne

>Palm Coast

>Waitng for dancing date

>

>