United Healthcare coverage


(Caitlin) #1

Hi,

I have to switch from Aetna to a new insurance and am looking at United Healthcare as my new insurance plan, with the choice between the private United Healthcare PPO 2500 and the ACA plan, Oxford United. I have a Minimed Paradigm pump and a Dexcom CGM.

I was told by the insurance broker that I should choose the ACA plan, which is about $100 more expensive per month, because the private insurance could deny coverage for the pump and the CGM (even with a prior authorization), whereas the ACA plan could not.

Has anyone had experience with coverage on either plan? Or do you know if it is better to be on ACA versus private?


(Dennis J. Dacey, PwD) #2

Hi Caitlin @CaitlinH, first as you are a new member here, I’ll Welcome you to TypeOneNation! I hope you find here what you may need, and urge to offer your suggestions to many other readers.
You didn’t say much about yourself and your health insurance needs other than that you use the same pump and CGM as I use. My insurance plan is probably different than yours, but United fully pays for both my pump and CGM supplies - I had the 20% copay for the “hardware” - the DME- durable Medical Equipment. I have the UHC Medicare Choice PPO which has the highest monthly premium but, for me, is the lowest out-of-pocket over the course of the year.
I suggest that you get directly in touch with a United agent/sales person and get a direct and accurate plan description and ask that person to find you the “best fit”.


(Caitlin) #3

Thanks Dennis. Good suggestion, I’ll reach out to an agent.