Anyone have experience with UnitedHealthCare PPO?

wahooker · Post by **wahooker** » Tue Aug 15, 2006 11:59 am

I'm switching Insurance companies, and will probably be going with UHC's PPO plan. (One of several my employer offers.)

Has anyone ordered from billmyinsurance.com, or from cpap.com and handling it with UHC's PPO plan?

On the billmyinsurance.com website, it says an upcharge may apply to UHC members, but I have no idea exactly what they mean by that.

Snoredog · Post by **Snoredog** » Tue Aug 15, 2006 12:45 pm

they have a monopoly contract with apria. so you are pretty much stuck with those yoyo's.

Guest · Post by **Guest** » Tue Aug 15, 2006 1:14 pm

It depends on where you live if you will be going through Apria or not. Like many insurances, Apria has been able to dominate in many areas, but there are still quite a few areas where they contract with someone else.
The PPO/PPC plans they have are actually quite good. They cover a great deal without requiring prior approval. Like most places, they will usually require PA for an auto unit.
I have no experience using them via billmyinsurance.

Sleepless in St. Louis · Post by **Sleepless in St. Louis** » Tue Aug 15, 2006 1:15 pm

I also have UHC, but I'm not forced to use Apria although a co-worker with the same plan was steered towards Apria. Not really sure why I was not. It may depend on what region of the country you are in as to what your DME choices are. The last time I looked on "bill by insurance" they were not able to work with UHC. I'll have to go look at that again, even though the DME that I'm working with has been pretty good in my opinion.

wahooker · Post by **wahooker** » Tue Aug 15, 2006 1:27 pm

Yeah, it looks like Apria has an office near me.

Does a patient have a right to pick their own DME, or can the insurance company mandate a specific one?

cpapjack · Post by **cpapjack** » Tue Aug 15, 2006 1:41 pm

wahooker wrote:Does a patient have a right to pick their own DME, or can the insurance company mandate a specific one?

You can go anywhere you want. Insurance companies cannot tell you where to get your equipment from. Keep in mind though, they only work with certain providers, which would be considered "in-network" and the ones they don't work with are considered "out-of-network."

bdp522 · Post by **bdp522** » Tue Aug 15, 2006 2:48 pm

I have HIP insurance. and in NY if you don't use apria they pay nothing. So I CAN use any DME but if I want my insurance to cover it I have to use Apria.

Brenda

cpapjack · Post by **cpapjack** » Tue Aug 15, 2006 2:51 pm

bdp522 wrote:I have HIP insurance. and in NY if you don't use apria they pay nothing. So I CAN use any DME but if I want my insurance to cover it I have to use Apria.

Brenda

Yeah, this is what I was trying to say. Not sure why I said it the way I did. ????

bbeck4x4 · Post by **bbeck4x4** » Wed Aug 16, 2006 6:25 am

UHC here in Utah just sent out letters that they have decided that they are no longer going to cover Nexium, and suggested that we try a over the counter pill for heartburn, and that heartburn is not a medical condition.