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United Healthcare - Switching and hoping for info

Discussion in 'Parents of Children with Type 1' started by MyBoys'Mom, Jun 30, 2011.

  1. MyBoys'Mom

    MyBoys'Mom Approved members

    Jul 20, 2009
    Hi. My employer is switching from Guardian to United Healthcare as of Aug 1. We have a choice of the Choice Plus PPO and the Choice Plus Definity HSA. I was wondering if anyone has any valuable advice with UHC they'd like to share. I'm used to Novolog being non-formulary, but I currently pay $40/mo or $80/3 mo. It looks like UHC non-formulary is $50/mo or $125/3 mo.

    There is something weird in their DME description saying that "In-Network and Out-of-Network Benefits for Durable Medical Equipment are limited to $2,500 per calendar year." For those of you with UHC, is this meaning that, once ds meets his deductible (or, with the HSA, we meet our family deductible), they only cover $2,500 of further incurred DME expense or does this mean I can only submit $2,500 per year of DME charges (that I'll have to pay because we've not yet met his deductible).

    Ugh, I hate insurance!

    Thank you :eek:
  2. Marie4Julia

    Marie4Julia Approved members

    Dec 11, 2008
    I know it varies with each employers plan, but when I had UHC, Diabetes supplies were considered their own benefit. Each prescription was filled with a copay of $10/month no matter what it was. Strips, pump supplies, insulin, ketone strips, everything. It was the best plan ever!

    You might want to check into it. This may be a part of your new plan as well. Good luck!!
  3. SarahKelly

    SarahKelly Approved members

    Nov 14, 2009
    we liked United Health Care, too...we had a little trouble getting the right number of test strips covered at first, but after a phone call and a letter all was fine. We even got a CGM covered by them, but then we changed insurance companies...grrr!
  4. virgo39

    virgo39 Approved members

    Jan 8, 2010
    We have United Healthcare too, but its sounds like the benefits offered through DH's employer are very different from what you describe with respect to Novolgo and DME.
  5. VinceysMom

    VinceysMom Approved members

    Mar 3, 2010
    I have UHC but my prescriptions are with Caremark... I'm not much help for you here tho... and my employer no longer had co-pays, we pay a percentage.

  6. sarahspins

    sarahspins Approved members

    May 5, 2009
    We are switching as of.. TOMORROW and I am terrified... just when I thought I had things figured out with Humana :(

    I keep reading that some of your are getting pump and CGM supplies covered by them through Pharmacy? I'm hopeful with that... but as I don't even have my cards yet and I don't know what our benefits will be exactly, it's a little daunting :(
  7. funnygrl

    funnygrl Approved members

    Nov 2, 2005
    Sorry, no experience with United Healthcare. I can relate to switching insurance though. I feel like I need to switch yearly! I've always had decent to excellent luck, but it's always scary. You never know what you're going to be facing no matter how good the plan looks on paper. Sometimes I feel like each time you switch you have to refight the battles you just fought.

    Good luck!
  8. GinaB

    GinaB Approved members

    Jun 15, 2009
    If you ended up with UHC I think you'll be happy. Different employers have different plans but we have been with UHC 13 years with no issues. I was really nervous how everything would work after dx but no problem. Our prescriptions are either $10, $20 or $40 each. Most the diabetes scripts have the lower copayment. We got both a pump and cgm and all the supplies with no problem. They have free services like a 'health coordinator' who called after dx to make sure we had all the information we needed and to help us access any services required. There is also a nursing line that is avaiable 24/7 to answer questions.

    Good luck with your decision.
  9. PatriciaMidwest

    PatriciaMidwest Approved members

    Mar 2, 2010
    The DME limit means they will stop paying anything considered DME after their portion reaches $2,500 each year. You will have to pay your deductible first, and then any copays. Sometimes plans will cover cgms or pump supplies under pharmacy instead of DME, it all depends on the options your employer has chosen. United insurance plan for Employer A can be very different from United Insurance for Employer B. Hope that makes sense.

    We had United when my daughter was first diagnosed, and had no issues with getting the pump and cgms approved immediately. Our plan did not have a DME limit. I wish someone would ban this practice of DME limits.

    Hope that helps.

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