HI 2bennySODC6,

A private message wouldn't go through to ask you about your experience with the Jaw Surgery. Did you have difficulty getting your medical back after and how long did it take?

 

DAL Pilot here who had the procedure in 2011. It’s called “maxillomandibular advancement. They cut the upper and lower jaw and pull them forward - in my case, lower jaw advanced 3/8”, upper about 1/4”. Had the procedure initially denied by UHC because the surgeon (Dr. Waite at UA, Birmingham; fantastic surgery team!) also wanted to cut and advance my chin a few millimeters. This is apparently a cosmetic procedure and UHC denied the entire surgery. I’d been suffering from severe obstructive sleep apnea my entire life and didn’t know it. Really started to feel the effects in my mid-40s. Just happened to marry a pediatrician at 46 who got me to the sleep doc. 18 months of CPAP (frequently recurring sinus infections, the hassle of keeping the FAA informed/special medical certification, etc) with the thing maxed out (try sleeping with the O2 mask on emergency) and I gave in to the surgery. This was not just to save the career; this was life saving surgery. And UHC denied it. Took three months and several letters from my sleep dr and the surgeon to get it approved. PM me if anyone wants to know about recovery, short and long term. In short, it worked. No more sleep apnea, no special medical. But, the recovery was challenging.

 

I got a letter from my doctor saying that they will not accept UHC starting in 2020.

 

Quite a few hospitals are doing the same, not to mention Walgreens.

 

Is this something that we are working on in negotiations? I can’t even get into a doctor whenever I need one, I have to go to urgent care. Prior to Delta I had BCBS and never had an issue seeing a doctor. Wonder if this is why?

 

So why do we have the worst health insurance in the industry?
Just saying....

 

This needs to be emphasized. Like vacation pay, we are a significant outlier here at the bottom of the industry.

 

.....but Americans LOVE their health insurance.....

(Relax, its just a joke)

 

I had jaw surgery a few years ago under UHC, but not with Delta.

I learned very quickly that the right hand does not talk to the left hand in that company. The procedure was medically necessary (not sleep apnea, but still necessary), but was denied due to an exemption. We had addressed that in the pre-approval letter (this fell under the exemption to the exemption), which apparently they didn't even read. They just saw the procedure code and denied it. After many back-and-forths, they finally approved it. Went in, had surgery, and guess what? After the procedure, they denied payment...because there was an exemption. No matter how many times I pointed out their own policy that it was covered, they denied it.

It took about a year, going up about 4 levels in the appeals process and finally threatening to sue them before they finally paid out.

Every doctor or specialist I have ever gone to loathes UHC. They never have issue with other companies, just UHC.

Good luck.

 

Back when I worked in the oil field I had UHC.

They denied my wife's claim as ER trip unnecessary after being broadsided by a pickup, and her car rolling over 3 times.

Because they found "nothing wrong other than bruises on her head"

Yeah. Head trauma. Usually a good reason to go to the hospital.

Morons.

I'm losing Tricare in September. Is DPMP through UHC as well?

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