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Denied... UHC

hersheymalone

By hersheymalone, in Insurance & Financing

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PATCHELTON    0

PATCHELTON
Posted

I have a different insurance (Blue Choice) but my BMI was 37-38. With that under my plan you had to have 2 or more co-morbidities (diabetes, sleep apnea, high blood pressure, high cholesterol, reflux, joint arthritis--basically any ailment affected by excess weight). I had all of the above except diabetes. Check with your insurance again. I would definitely appeal the denial.

My insurance paid for the surgery, a night in the hospital, but they don't pay for fills. Go figure. . .

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missinme    0

missinme
Posted

Don't give up just yet....if you have an associated co-mobility such as diabetes, high blood pressure or high cholesterol then you have an argument with your provider. Also pick up the book "Weight Loss Surgery for Dummies" there is a section on what to do when the insurance company doesn't agree with your physican decision.

My BMI was less than your and I was just banded with insurance approval this Monday. I am sore as all get out, but do NOT regret my decision.

Good luck.

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hersheymalone    0

hersheymalone
Posted

I am just sick about this... I never use my insurance and then when I decide I want to, they deny me. Crazy.... I just wonder how the appeal works... Argggg......

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Jodi_620    37

Jodi_620
Posted

You don't have any weight related health conditions? I have UHC and like most insurances they will not make any exceptions to the guidelines. You have to be 35-40 with co-morbities or 40+.

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Chris61    0

Chris61
Posted

I was on the border in regards to BMI. I can forward you a copy of a letter that we used. I was wondering if the doctor just said pain in the knees or other issues or did he use technical names? I would talk witht he doctor and see how he did the letter.

Chris

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KingsFan    0

KingsFan
Posted

I just found out that UHC denied me because my BMI is too low (35). I already had my doctor write a letter and I will send off an urgent appeal tomorrow. My surgery is scheduled for September 12 and UHC said they might treat the appeal as urgent and decide within 72 hours. Good luck to all of us who are at the mercy of insurance companies!

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Go To Topic Listing Insurance & Financing

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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      1. LeighaTR

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        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

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        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

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      Officially here for a long time, not just a good time💪
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