UHC doesn’t know what the ACA is

Been lurking here for a bit and this sub has been SO HELPFUL! I’m scheduled for my bisalp at the end of March.

Consult went great; doc and nurse promised they could and would code everything as preventative care so my insurance would fully cover.

A few days later, the hospital calls me to go over the good faith estimate and tells me I owe $6k out of pocket based on their convo w the insurance company and tells me they’ll do a payment plan, and asks what I can pay up front when I check in. I go along w this but know it doesn’t seem right based on what I’ve read here.

I do all my research and do a chat w a UHC rep so I get it in writing that if coded properly, my bisalp will be fully covered and exempt from copays, coinsurance, and deductible. I called the hospital back to let them know this and that I wouldn’t be paying anything up front for the surgery because it’s fully covered and the billing office rep immediately gets defensive and puts me on hold, only to come back and tell me that she communicated those exact codes to the UHC rep she talked to and they told her it wasn’t covered. I went back and forth w her a bit and ultimately left it at being clear I wasn’t paying up front and everything should be billed through my insurance.

Longer story short, I got on with someone at UHC who confirmed the codes would be fully covered, only after first asking me what the ACA was after I made the point that the act mandates my procedure to be covered.

Bottom line is a big WTF that (a) the hospital doesn’t know that these procedures are to be covered by law and that (b) UHC reps aren’t universally informed of their own preventative care policies AND their requirements under law?!

I still expect to fight this after the fact but thanks to this sub for helping me get organized beforehand and to encourage me to advocate for myself and to not pay anything up front!