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United Healthcare Through Hca Hospitals

Can anyone share their experience with HCA's plans on United Healthcare? I work for an HCA hospital and am starting the journey towards getting surgery. So far I've been to the seminar, had the initial consult with the surgeon, and have been to the first medical manage weightloss appointment with the dietician. It's all out of pocket so far, because I have such a high deductible. I signed up for the high deductible plan before realizing that bariatric surgery was covered. Its the $1,900.00 deductible with 70/30 after deductible met. Fortunately the hospital stay is covered 100% with HCA hospitals.

So what are any of your stories with UHC (even if you don't have HCA's plan)? Any unforseen hurdles pop up? Did they move quickly? Since I started this month we're thinking I can possibly squeeze in at the end of the year.... fingers crossed.

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  • Author

Sorry to hear that :( I know they cover bariatric surgery here... they do have the hoops to go through including the 6 month medically managed weight loss attempt :( That blows. I've been BMI of 40+ for MANY years... its not like 6 months will change that.

  • Author

If I had the cash I'd self pay in a heartbeat. :-/

I belive UHC is simply a coordinating company. They have the plans written, and then the employer has the option to change and adjust as they please. That's why each year when it's "open enrollment" the policies can change slightly, not change at all, or change drastically. It all depends on how much the company wants to pay for the coverage. Then when we go to use the coverage and file a claim, the decisions UHC make are based on what the employer has told them. I'm lucky, my company is very generous. UHC will cover my surgery 100% with just a BMI of 35+ w/co-morbities, or 40+ without, and a 5 day coordinated care notice. The only hang up I've had so far is the phych. doctor held on to my evaluation waiting for the doctor's office to request it. I met the phych last month (June)! When I called the insurance they had no information regarding coverage request, the dr's office said they were waiting on the eval, the phych said she had just received an email from the dr's office just before I called and she doesn't send it to them until they request. SOMEONE dropped the ball. Good thing I called! Guess we'll see if this speeds up the process any. Good luck everyone, I know it can be a hassle, and I hope everyone has a positive outcome financially, physically and emotionally.

I work for HCA and have UHC. Easy route for me. I have 80/20 coverage with $400 deductible with a $3000 out of pocket max. So far I have had the following expenses

EGD

166 to MD

75 to facility

have not recieved a bill from anes yet. expect it to be around 400

10 to radiology for my chest xray reading.

Cardiology Clearance

bill pending should be 20%

Psych Eval

38

Nutrition visits

All 3 totally covered.

VSG and Hiatal Hernia Repair.

Paid 301 up front to md for VSG. HH should be about the same but will be billed for that.

Hospital stay covered 100%

Anesthesia charges still pending.

From my initial consult to surgery was exactly 101 days. I was approved on first submission to UHC. It took approx 1 week to be approved.

  • 4 weeks later...
  • Author

Oh and Tinker - like your signature - also an RN.

I have UHC - and they approved me within 3 business days - they are awesome!!

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