I managed to get pre-authorization on my outpatient ketamine infusions in early 2010 from UHC in RI. But my coverage is not an HMO plan. I was initially denied and had to appeal multiple times. Since the plan was already covering the infusions of at least one other individual in the state, I knew that eventually I had a decent chance of prevailing - and I did win my appeal. But the amount that the plan paid was far less than what they agreed, and SIGNIFICANTLY less than what my doctor charged on a daily basis.
My case was a WC case, and I won my court case in early June 2010. Since then, WC has been paying for my infusions.
Check out the Ketamine Klub on FB for more info on dealing with insurance issues. Good luck to you!! Xoxo Sandy
Quote:
Originally Posted by numb
Hi All,
Does anyone on this forum has UnitedhealthCare signature value HMO plan? Do you know whether or not it covers Ketamine infusion and SGB/LSB? Is it difficult to get the authorization?
I used to have BCBS PPO plan and i have the freedom to go to any doctors and i don't have any problems of getting the care so far. However, my employer only offer either Kaiser or Unitedhealthcare. I did not like Kaiser because i was not offer the care that i needed for my RSD. I was lucky at the time because i also had another PPO insurance. So if you can tell me about the Unitedhealthcare HMO, i truly appreciated your help.
Thanks.
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