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My insurance denied - I need to prove 5 years obesity - HELP

My insurance denied coverage because they say I did not show 5 years obesity. I have had a bmi of 43 or greater for the last 10 years. After long consideration, I finally made what I thought was a great decision, just to be disappointed. I have only been with my primary doctor for 3 years. Before that, I did not have health insurance. I did not go to medical doctors during that time...maybe once or twice if I absolutley had to, but they did not weigh me. Does anyone know what else the insurance company will accept for proof of obesity for 5 years?

 

Who the heck goes to the doctor and says, "oh you better weigh me because in 5 years, I might have surgery!"

 

Devestated in New York!:thumbup:

8 Comments

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stephaniel71

LAP-BAND Patients

My insurance denied coverage because they say I did not show 5 years obesity. I have had a bmi of 43 or greater for the last 10 years. After long consideration, I finally made what I thought was a great decision, just to be disappointed. I have only been with my primary doctor for 3 years. Before that, I did not have health insurance. I did not go to medical doctors during that time...maybe once or twice if I absolutley had to, but they did not weigh me. Does anyone know what else the insurance company will accept for proof of obesity for 5 years?

Who the heck goes to the doctor and says, "oh you better weigh me because in 5 years, I might have surgery!"

Devestated in New York!:lol:

chellt75

LAP-BAND Patients

Hi devastated in NY,

I am so sorry to hear you were denied... My ins. also required a 5 yr weight history, which i could not provide :lol: However, I was approved on the first try and I believe it has something to do with the letter I submitted chronicalling my struggle....Can't say for sure, but the nurse suggested it....Though I am sure are situations are very different, I would be glad to send yo a copy as a jumping off point....

chellt

vinny09

LAP-BAND Patients

hello devastated in NY, I can only imagine what you are going thru, my ins. req. 3 years history which I didnt have but as chellt mentioned I did write a lengthy letter along with dated pics which helped me. talk to your doctor and see about appealing the decision its never set in stone. wishing you the best of luck... vinny

mudd0327

LAP-BAND Patients

Im sorry to here that also. Which insurance carrier do you have?

stephaniel71

LAP-BAND Patients

Thank you for your encouragement. That was my next step to submit pictures and a letter. I figured it couldn't hurt. It is great to hear it worked for you. My insurance company is United Healthcare. Chellt75 thank you for offering your letter. If you can send that would be great. Any help would be appreciated.

cookie4812

LAP-BAND Patients

Same thing happened to me. This year my BMI was 40, approx 38 to 39 for the previous 4 years. They said I wasn't fat enough for those previous years, This is United Health Care!!!!

Guest

Guest

Guests

Received my ok from the insurance company today. My family isn't thrilled with the decision but they are coming around.

stephaniel71

LAP-BAND Patients

I did finally get approved 2 1/2 months later. For all of you out there struggling with your insurance company, don't give up. That is what they want you to do. Just keep appealing and appealing.

Guest
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