Question:
my company is self insured but switching to united healthcare as the
administrator (from BCBS)...
this is supposed to be barrier free coverage, meaning you can use any provider
or hospital...yada yada...
but what im wondering, of course: those of you who have united health care...
do they cover the abc's....have you had any problem with that?
Answer:
My husband's company has a group plan (also in Florida, as you are).
Although United generally doesn't cover injectables, they do cover Copaxone
($1,200 per month) and won't cover B-12 injections (for diagnosed pernicious
anemia) at $10 per year -- go figure.
The way our policy works is, no referral needed for a listed provider and
like old-fashioned insurance, I think they only pay 70% if you go to an
unlisted provider. I don't know if the all the hospitals in the area are
providers, but I know all the major ones are (in my area that includes all
of the Baptist Healthcare Systems and the UofM/Jackson Memorial Hospital).
I think you'll be pleased, Lisa. Unlike our former healthcare insurance
(AvMed -- eeeeeeeyikes!), United has been no-fuss, no-muss.
United Heath Care is my provider. They have been great, no questions.
I go where I want, no referral needed. They cover Avonex with a $9
co-pay to me. Every company signs up for diffrent plans with them so
your co-pay may be different. I have a $10 office visit co-pay and
normally a $3 co-pay on prescriptions.
They have paid for 4 MRIs, a LP, neuro visits, chiropactor and no
questions yet. Sometimes they call and want a doctor's transcript.
Could not bring myself to snip any part of the above. My company does
have United Healthcare. I am on that plan. I go see approved
providers. Prescriptions are 15 dollars - all of them including my
Avonex. 10 dollar co-pay for doctor visits. Out-patient proceedures
have been no charge so far. As long as your provider files promptly
there should be no problem. The out-patient facility where I used to
get my IV steriods was over a year in filing twice. They kept sending
me bills. I talked to the United HealthCare folks. They told me not to
pay and if the out-patient facility kept sending me bills, refer them
to United HealthCare.
We have UHC - used to have anthem . They sucked - could not tell their ass
from a whole in the ground. We have the UHC PPO option which allows self
referal - If your company has several options make sure you pick the right
one! For whatever reason the one that does NOT allow self referals cost
more. Go figure. Our scripts are through Merck-Medco, don't know if that
is a UHC thing or not. Oh and our dental is still Anthem.
