Got Denied....Need help with appeal letter

Hi Friends  After waiting 4 weeks for my insurance to make a decision, they denied my request for RNY, saying that I don't have 5 years of morbid obesity.  My BMI was 33.5 in August of 2003.  Now it is 40.5 and I take meds for blood pressure, cholesterol and arthritis.  I can't remember exactly when I started the blood pressure meds, but it has been 3-4 years, I think. How can I convince them that I can't wait?
I don't want to continue to gain more weight and get more and more unhealthy just because they want 5 years.  Thanks, Sherri

Sherri, Sorry I don't have any advice, just wanted to send some hugs.  I am in the process of trying to get approved also.  I know my BMI may be an issue also.  It is 41 now but was under 40 up until this year but not under 35.   Do you mind me asking what insurance you have?

Thanks, Dani!  I have United Health Care.

Sherri, I just wanted to send you special love and hugs. I know that you must be disappointed but just remember this~If God brings you to it, He will get you thorugh it. He has brought you this far. Just remember that. Keep on plugging away and I am sending prayers for you.

Brenda,  Thanks so much.  I am disappointed and a bit depressed, your prayers make it better. Sherri

Sherri, I, too, was denied by my insurance.  I found out that the first review is done by an independent medical person (mine was a pediatrician).  He informed me that if any of the criteria are not met then he has to deny it.  So I appealed - had letters from my cardiologist, endocrinologist, family doc.  It was finally approved.  So my advice, you hang in there and keep appealing.  I've been working on mine for over a year.  My surgery is on July 7th (5 days to the birth of my baby pouch! ) Nervous, but I am know that this is the best thing for me.  I am diabetic and this is the best treatment available for it.  Good luck to you in your journey - use this set-back to give you more determination to forge through - it'll pay off.  Jackie

Jackie, Congratulations on your upcoming surgery! How long did it take to get your info together and your appeal approved? Thanks, Sherri

Sherri

I also have United Health Care.  I had no problem.  Can you have your doctor go back 5 years to show your weight and blood pressure numbers over those years? Have the doc put those in your letter to the insurance company. If your doctor doesn't have these numbers...get the doctors you DID have over the last 5 years. ANY doctors....ortho docs for arthritis  etc.

Good luck~

hugggggggggs
Janene