full image - Repost: struggling to confirm insurance for Denver Health (from Reddit.com, struggling to confirm insurance for Denver Health)
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I'm planning on going to Denver Health for top surgery and I submitted my surgical interest form a couple months ago. they responded with an info packet with guidelines and steps for the process. I've finally had time to sit down and work on the first step, which is confirming if United Healthcare will cover my surgery.I must admit I don't understand a lot about insurance, or my policy. every year before open benefits enrollment at my job begins we have a 2 hour long meeting going over what all the terms mean, and they still don't make sense to me despite trying desperately to understand them. plus, the website for my policy is garbage and isn't helpful at all either. so I'm not exactly 100% sure what's going on. I've never had to do any of this before.I called the number on the back of my card and spoke to an advocate. I asked specifically if a mastectomy would be covered under a gender dysphoria diagnosis, and she said yes, but also mentioned that prior authorization was needed first. I understand that prior authorization is a process that the doctor has to initiate, which doesn't make sense to me because I have to confirm all of this stuff and send in my letters of support before I can even schedule a consultation at all.I asked about the letters too, like how many I'd need, and she literally just told me that the doctor has to tell me which again makes no sense at all. I can't find specific details about my plan, I can only find the general guidebook which says that I need 2 letters of support from a therapist and physician. but should I just assume that it's the same for my specific policy?I did get confirmation that both of the top surgeons there are in network, so at least there's that. I'm just at a loss now for what I should do next. it seems like they'll cover my top surgery but I really didn't get a lot of clarification about literally anything. I know that Denver Health has patient advocates for their LGBTQ services but they explicitly said in the info packet that they can't help me with the insurance process.should I just keep going along in the process and pretend that everything is fine? the next step is sending my medical records and letters of support in. should I begin asking my doctor and therapist to write them for me? should I keep calling my insurance? am I just overthinking it all?basically, if anyone who knows more about insurance than me can offer advice or help clear some of this stuff up for me, I'd appreciate it. Denver Health's guidelines are really confusing for me and I'd really appreciate any insight anyone might have. thank you so much!!!
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