UHC Sucks! (rant)

So................... Apparently having a BMI of 47, sleep apnia, and hypertension isn't enough to have surgery.  UHC got my med history and since my BMI was at like 39 for one year, I am denied...for now.  Dr. Tom's office is none too happy right now, and we both think that UHC is trying to snake their way out of paying for my surgery since my wife was banded on Feb. 25th.  They sent in the appeal info and now have postponed my surgery.  Both the office staff and I are utterly dumbfounded by this, because none of this was needed for my wife and she was approved and banded all within 2 months.  They had originally tried to say that I was not covered for the procedure (morons) then it was changed that I needed a BMI of over 40 for 5 years.  Also they wanted a 6th year of information.  I do want to say I am very grateful for Dr. Tom's staff and all of the help and support they are giving me.  They truely do go above and beyond. 

Contact your employer.  I had a similar problem.  I was approved to have bypass then suffered PE and had to wait in the mean time was diagnosed with Crones so no Bypass.  Lap band was recomended.  Insurance said my bmi was too high, by .5.  My doc said (with asian accent) "HOw you be too fat for weight loss surgery". I had him, and my orthoopeadic all write letters along with Dr. Tom's appeal.  THen called my hubby's company to complain.  Things were taken care of in a little over a month.  I am now a member of the Band.   Keep your chin up and have faith. I will keep you in my prayers. Amy K

Thanks. I just don't understand how they cover one person on my policy, but not the other.  That is the Million $ question.  Like I said, Dr. Tom's office is none too happy right now either.

LOL   oh my gosh I am laughing so hard at the  accent thing.....tooo funny

Now I'm just sitting here thinking like an armchair lawyer!!  Didn't they set their own precedent by NOT asking your wife for her info?  If they didn't how can they get away with treating you differently???  I know there are lawyer's who specialize in obesity law but have no idea where you'd find one.  Would love to hear what a real lawyer would say about it! I suppose the insurance companies just want to keep paying for everyone's comorbidities and keep their fingers crossed you die off early so the won't have to put any more of "their" money out than they have to.

Everyone involved is thinking the same thing.  Prescident was set with my wife and that I should follow suit.  If you put out information back to back, it makes absolutely no sense. Me - BMI 47.5, Sleep Apnea, Hypertension Her - BMI 43.1, Hypertension, Ovarian Cysts, Migraines We are all dumbfounded.

I gotta say to you though that you are such a cool hubby for having let your wife go first!  Richard and I discussed who was going first when we decided to do this and he wanted me to be first after I told him my insecurities of having a healthy hot looking husband while I was struggling to catch up!  LOL....good thing he's not as insecure about that kind of thing!  I think the other aspect though was I could learn how to be a good bandster and then he could just take my experience and follow suit!  Well, that and I'm the cook around here!

Never give up..and believe me..Dr. Sonnanstine loves a good fight....ahem..challenge..( sorry doc) Hang in there he and his staff will do whatever they can to help you!