Re: Need some answers....

[Guest guest]

HI! I have United Healthcare POS, and they paid 100%! It was covered as an

in network benefit. Best thing I've ever done, and it was virtually

free!!!!

Blessings,

~Amy.

_____________________________________________

Amy S. Poe

MGB 5/22/2000

280 * 213 * 140

READ MY STORY ONLINE:

http://onhealth.webmd.com/women/in-depth/item/item%2C91744_1_1.asp

Need some answers....

Hey you wonderful people you.

The insurance gal told me to get a letter ready to include with the PCP's

letter.

I have been with this PCP for a year. and I have only visited with him once.

SO he does not have my whole history and has never really asked. :-I not

sure

what he will write. I like the idea of putting word on a page for him. but

i am not sure what to write. We have only been back in AZ for 17 months.

and with this insurance that long. Hmmm WILL that hinder or help the

process.

The ins gal said that without pre-approval they will cover 80% of the cost.

With pre-approval they will cover 100%. but if they review it for approval

and do not approve. then they will pay nothing. Hmm what a twist. To go for

the approval. But they state very clearly that they will cover it if

diagnosed with morbid obesity. I have BMI of 55 that is clearly morbidly

obese. YES??? how can they turn me down?? I guess I am afraid that because I

have always been so healthy that they will wait until I am having alot more

medical problems.

My DH says that I should get it done no matter what. but he will not say

which way I should go for. :-( I really would like to have them pay 100%

but

I do not want to risk losing the 80% payment. I really hate tough decisions

!! !

So does anyone else have united Healthcare POS? and how did you go about

getting your surgery?

Thanks,

Anita

Tucson

[Guest guest]

Hi Anita,

One thing you have to consider.......you should only be paying 20% of

the

contracted charges. As an example I had 80/20 coverage for out of network. I

fully expected to have to pay 20% of approximately $15,000 or approximately

$3000. When all the bills came in I was very pleased to find out I only had to

pay 20% of the allowable charges. I had a $450 deductible and with the 20% I

ended up with total expenses of about $1,200. Not bad for a life changing

operation. That was for hospital, anesthesia and Dr.R.

I hope this helps with your decision.

Best Wishes,

Genz

ninibee@... wrote:

> Hey you wonderful people you.

>

> The insurance gal told me to get a letter ready to include with the PCP's

> letter.

> I have been with this PCP for a year. and I have only visited with him once.

> SO he does not have my whole history and has never really asked. :-I not sure

> what he will write. I like the idea of putting word on a page for him. but

> i am not sure what to write. We have only been back in AZ for 17 months.

> and with this insurance that long. Hmmm WILL that hinder or help the process.

>

> The ins gal said that without pre-approval they will cover 80% of the cost.

> With pre-approval they will cover 100%. but if they review it for approval

> and do not approve. then they will pay nothing. Hmm what a twist. To go for

> the approval. But they state very clearly that they will cover it if

> diagnosed with morbid obesity. I have BMI of 55 that is clearly morbidly

> obese. YES??? how can they turn me down?? I guess I am afraid that because I

> have always been so healthy that they will wait until I am having alot more

> medical problems.

> My DH says that I should get it done no matter what. but he will not say

> which way I should go for. :-( I really would like to have them pay 100% but

> I do not want to risk losing the 80% payment. I really hate tough decisions

> !! !

>

> So does anyone else have united Healthcare POS? and how did you go about

> getting your surgery?

>

> Thanks,

> Anita

> Tucson

>

>