Question regarding United Health Care / Definity Health

Mita · 10-27-2005, 09:59 AM

It is open Enrollment here at work and I am thinKing of changing carrieres just because of the out of pocket cost. Does anyone have any info they can share regarding the carrier above?? The plan allots you 1500.00 up front for a family and you have no co pays at the Dr's office. All prescription cost as well as the dr visit comes out of the alloted money.. Cost wise it would save me but I do not want to change and regret it...
The only downer right now is neither my band doc or my childs Dr's is in the net work so a little more would come out of my account.

MorningHibiscus · 11-08-2005, 12:34 PM

I just chose in Open Enrollment to go on UHC PPO HSA, which is DefinityHealth.

I haven't found any answers about weight loss surgery, but think it will continue UHC policy for my company, which probably is not good news, since I had 2 insurance specialists in WLS doctors offices tell me I was not covered for it. It is still cheaper and portable, and I can hope and work on it. Or go to Mexico, which are all the options I had before.

I figure it can't hurt.

**Alexandra** · 11-08-2005, 01:10 PM

Bubba, what happens after the $1500 is used up? That doesn't buy what it used to, particularly if you're going out of network for medical care.

Mita · 11-08-2005, 02:17 PM

I called and checked and my doc is in network and they do accept Definity. Now after the 1500.00 is used up then it is out of pocket up to 3 grand. Then they kick in like BCBS right now 80/20. My plan is to get a prescript for all my meds in Dec for 3 months then cross my fingers that we have a good year. I will try it for this next year and if it does not work for me at least I will know. As of right now I owe about 3 grand if I could get a little help it would be worth it..

Wheetsin · 11-09-2005, 07:23 PM

Hmm - I've been considering the same thing. I have UHC Midwest, I believe it's an EPO. I know my doctor-to-be has had RNY procedures covered by my insurer but I don't know about LAP-BAND®. And sorry - I don't know anything about Definity. :(

nannerpuddn · 03-12-2006, 03:05 AM

i have definity health and it works like regular insurance only difference is that your deductible is after u use up the first 2000 in my case. the first 2000 of everything including prescriptions is covered 100 percent then the deductible has to be met then they pick up and cover 80 percent on everything else. And its best to use only doctors in your network if you are considering banding. i am trying to get approved for it and if i do it will only cost me 2600 out of pocket. but i have noticed that definity has covered banding 100 percent if its a medical prevention claim i saw where some patients were covered 100 percent even if they havent met the deductible if your in network doctor files it under a medical nessicity lol cant spell. it has to be filed under prevention to be covered like this.