Guest guest Posted January 14, 2004 Report Share Posted January 14, 2004 If you ask your surgeon for the fee u could figure this out.... my 20% is $5000 Finally approved!!! Well, after 5 months of back and forth with my OS and my insurance (United Healthcare) I was approved for upper and lower jaw surgery. What sucks is that if I would of had this done last year, my insurance was 90/10. Now,it's 80/20. So, basically, my question is, does anyone have an idea what my 20% will come to for upper and lower? Thanks everyone. I'm so excited. It's tentatively planned for June 20th. But that was the dummy date my OS gave to the insurance company -- it may be (hopefully) sooner. -Blake _____ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 14, 2004 Report Share Posted January 14, 2004 If you ask your surgeon for the fee u could figure this out.... my 20% is $5000 Finally approved!!! Well, after 5 months of back and forth with my OS and my insurance (United Healthcare) I was approved for upper and lower jaw surgery. What sucks is that if I would of had this done last year, my insurance was 90/10. Now,it's 80/20. So, basically, my question is, does anyone have an idea what my 20% will come to for upper and lower? Thanks everyone. I'm so excited. It's tentatively planned for June 20th. But that was the dummy date my OS gave to the insurance company -- it may be (hopefully) sooner. -Blake _____ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 14, 2004 Report Share Posted January 14, 2004 I just re-read my policy. I have a $500 deductable, and a $2000 maximum. So, I'm going to pay $2500 out of pocket. Thank goodness I took out $5000 Flex-benefits for this year (1/2 this year goes to paying my braces, and other 1/2 goes for out-of-pocket). Thanks everyone! -Blake > If you ask your surgeon for the fee u could figure this out.... my 20% > is $5000 > Finally approved!!! > > > Well, after 5 months of back and forth with my OS and my insurance > (United Healthcare) I was approved for upper and lower jaw surgery. > > What sucks is that if I would of had this done last year, my > insurance was 90/10. Now,it's 80/20. > > So, basically, my question is, does anyone have an idea what my 20% > will come to for upper and lower? > > Thanks everyone. I'm so excited. It's tentatively planned for June > 20th. But that was the dummy date my OS gave to the insurance > company -- it may be (hopefully) sooner. > -Blake > > > > _____ > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 14, 2004 Report Share Posted January 14, 2004 very good Finally approved!!! > > > Well, after 5 months of back and forth with my OS and my insurance > (United Healthcare) I was approved for upper and lower jaw surgery. > > What sucks is that if I would of had this done last year, my > insurance was 90/10. Now,it's 80/20. > > So, basically, my question is, does anyone have an idea what my 20% > will come to for upper and lower? > > Thanks everyone. I'm so excited. It's tentatively planned for June > 20th. But that was the dummy date my OS gave to the insurance > company -- it may be (hopefully) sooner. > -Blake > > > > _____ > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 14, 2004 Report Share Posted January 14, 2004 Congratulations! Do you know what they said to get it approved? > Well, after 5 months of back and forth with my OS and my insurance > (United Healthcare) I was approved for upper and lower jaw surgery. > > What sucks is that if I would of had this done last year, my > insurance was 90/10. Now,it's 80/20. > > So, basically, my question is, does anyone have an idea what my 20% > will come to for upper and lower? > > Thanks everyone. I'm so excited. It's tentatively planned for June > 20th. But that was the dummy date my OS gave to the insurance > company -- it may be (hopefully) sooner. > -Blake Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 15, 2004 Report Share Posted January 15, 2004 I got my HR department involved, as well as the consultant that we used when we negoatiated with UHC. I was 'In Review' for 6 weeks, and it was supposed to be 15 days! I just got more people from my side involved with it. However, I don't know what my OS said. I'm meeting with him next month, so I'll report back to the board then. > > Well, after 5 months of back and forth with my OS and my insurance > > (United Healthcare) I was approved for upper and lower jaw > surgery. > > > > What sucks is that if I would of had this done last year, my > > insurance was 90/10. Now,it's 80/20. > > > > So, basically, my question is, does anyone have an idea what my 20% > > will come to for upper and lower? > > > > Thanks everyone. I'm so excited. It's tentatively planned for June > > 20th. But that was the dummy date my OS gave to the insurance > > company -- it may be (hopefully) sooner. > > -Blake Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 15, 2004 Report Share Posted January 15, 2004 I have United Healthcare too and I just received my dirst denial letter and am in the process of appealing it. Did your first denial letter say anything to the extent of " treatment of malocclusion is specifically excluded? " That's what mine said. I'm also like you, where last year it would have cost me 100% for in network with no out of pocket maximum and 90/10 for out of network and $1,500 out of pocket maximum to 90/10 in network, $1,000 out of pocket max and 70/30 out of network, $2,000 out of pocket maximum. So the most I will pay for my surgery will be $3,500 (with deductibles). You should take a look at what your out of pocket maximum is and that's the most you will have to pay. > > > Well, after 5 months of back and forth with my OS and my > insurance > > > (United Healthcare) I was approved for upper and lower jaw > > surgery. > > > > > > What sucks is that if I would of had this done last year, my > > > insurance was 90/10. Now,it's 80/20. > > > > > > So, basically, my question is, does anyone have an idea what my > 20% > > > will come to for upper and lower? > > > > > > Thanks everyone. I'm so excited. It's tentatively planned for > June > > > 20th. But that was the dummy date my OS gave to the insurance > > > company -- it may be (hopefully) sooner. > > > -Blake Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 15, 2004 Report Share Posted January 15, 2004 Thanks! I would really appreciate it! > > > Well, after 5 months of back and forth with my OS and my > insurance > > > (United Healthcare) I was approved for upper and lower jaw > > surgery. > > > > > > What sucks is that if I would of had this done last year, my > > > insurance was 90/10. Now,it's 80/20. > > > > > > So, basically, my question is, does anyone have an idea what my > 20% > > > will come to for upper and lower? > > > > > > Thanks everyone. I'm so excited. It's tentatively planned for > June > > > 20th. But that was the dummy date my OS gave to the insurance > > > company -- it may be (hopefully) sooner. > > > -Blake Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 15, 2004 Report Share Posted January 15, 2004 Thanks! I would really appreciate it! > > > Well, after 5 months of back and forth with my OS and my > insurance > > > (United Healthcare) I was approved for upper and lower jaw > > surgery. > > > > > > What sucks is that if I would of had this done last year, my > > > insurance was 90/10. Now,it's 80/20. > > > > > > So, basically, my question is, does anyone have an idea what my > 20% > > > will come to for upper and lower? > > > > > > Thanks everyone. I'm so excited. It's tentatively planned for > June > > > 20th. But that was the dummy date my OS gave to the insurance > > > company -- it may be (hopefully) sooner. > > > -Blake Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 15, 2004 Report Share Posted January 15, 2004 Thanks! I would really appreciate it! > > > Well, after 5 months of back and forth with my OS and my > insurance > > > (United Healthcare) I was approved for upper and lower jaw > > surgery. > > > > > > What sucks is that if I would of had this done last year, my > > > insurance was 90/10. Now,it's 80/20. > > > > > > So, basically, my question is, does anyone have an idea what my > 20% > > > will come to for upper and lower? > > > > > > Thanks everyone. I'm so excited. It's tentatively planned for > June > > > 20th. But that was the dummy date my OS gave to the insurance > > > company -- it may be (hopefully) sooner. > > > -Blake Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 15, 2004 Report Share Posted January 15, 2004 Hi, No, you must of misunderstood -- I never for a denial. It was all " We lost your paperwork, please refile " , and then it was 'in review' for 6 weeks. After I got my HR department involved, I was suddenly approved. I'm getting upper and lower, and a 24-48 hour stay in hospital. I'm going to ask how my OS got this approved -- maybe they'll let me see the file? I don't know for sure, but I'll write back what I find out. I'm going to see him again in February. > > > > Well, after 5 months of back and forth with my OS and my > > insurance > > > > (United Healthcare) I was approved for upper and lower jaw > > > surgery. > > > > > > > > What sucks is that if I would of had this done last year, my > > > > insurance was 90/10. Now,it's 80/20. > > > > > > > > So, basically, my question is, does anyone have an idea what my > > 20% > > > > will come to for upper and lower? > > > > > > > > Thanks everyone. I'm so excited. It's tentatively planned for > > June > > > > 20th. But that was the dummy date my OS gave to the insurance > > > > company -- it may be (hopefully) sooner. > > > > -Blake Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 15, 2004 Report Share Posted January 15, 2004 Also, I think they spoke about TMJ -- when you say maloclusion, was it skeletal or dental? Dental maloclusion WON'T be covered, becasue those can be fixed with braces -- skeletal is covered as far as I know. But I also think different companies get different things covered even with the same insurance carrier. > > > > > Well, after 5 months of back and forth with my OS and my > > > insurance > > > > > (United Healthcare) I was approved for upper and lower jaw > > > > surgery. > > > > > > > > > > What sucks is that if I would of had this done last year, my > > > > > insurance was 90/10. Now,it's 80/20. > > > > > > > > > > So, basically, my question is, does anyone have an idea what > my > > > 20% > > > > > will come to for upper and lower? > > > > > > > > > > Thanks everyone. I'm so excited. It's tentatively planned > for > > > June > > > > > 20th. But that was the dummy date my OS gave to the > insurance > > > > > company -- it may be (hopefully) sooner. > > > > > -Blake Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 15, 2004 Report Share Posted January 15, 2004 Also, I think they spoke about TMJ -- when you say maloclusion, was it skeletal or dental? Dental maloclusion WON'T be covered, becasue those can be fixed with braces -- skeletal is covered as far as I know. But I also think different companies get different things covered even with the same insurance carrier. > > > > > Well, after 5 months of back and forth with my OS and my > > > insurance > > > > > (United Healthcare) I was approved for upper and lower jaw > > > > surgery. > > > > > > > > > > What sucks is that if I would of had this done last year, my > > > > > insurance was 90/10. Now,it's 80/20. > > > > > > > > > > So, basically, my question is, does anyone have an idea what > my > > > 20% > > > > > will come to for upper and lower? > > > > > > > > > > Thanks everyone. I'm so excited. It's tentatively planned > for > > > June > > > > > 20th. But that was the dummy date my OS gave to the > insurance > > > > > company -- it may be (hopefully) sooner. > > > > > -Blake Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 15, 2004 Report Share Posted January 15, 2004 Also, I think they spoke about TMJ -- when you say maloclusion, was it skeletal or dental? Dental maloclusion WON'T be covered, becasue those can be fixed with braces -- skeletal is covered as far as I know. But I also think different companies get different things covered even with the same insurance carrier. > > > > > Well, after 5 months of back and forth with my OS and my > > > insurance > > > > > (United Healthcare) I was approved for upper and lower jaw > > > > surgery. > > > > > > > > > > What sucks is that if I would of had this done last year, my > > > > > insurance was 90/10. Now,it's 80/20. > > > > > > > > > > So, basically, my question is, does anyone have an idea what > my > > > 20% > > > > > will come to for upper and lower? > > > > > > > > > > Thanks everyone. I'm so excited. It's tentatively planned > for > > > June > > > > > 20th. But that was the dummy date my OS gave to the > insurance > > > > > company -- it may be (hopefully) sooner. > > > > > -Blake Quote Link to comment Share on other sites More sharing options...
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