I was denied today.....

I got word today that my insurance, United Health Care (Choice Plus), denied me because I have a BMI of 39.5 and they require a BMI of 40 or greater. I am 115 lbs over-weight, you think that would be enough. I will find out tomorrow if they approve, with co-morbidities, which I do ( back pain and asthma ). The .5 difference is only 4 lbs. Thanks, Sandy

Sandy, sorry to hear about your ins today. One positive thing is that you know that your ins has coverage for WLS now you'll be able to work around the co morbid issue. I had UHC also thru America WestAirlines, I was blessed to be approved first time out. Stay on the ins person at your surgeon's office to re submit your reconsideration in a manner that the ins will buy off on. In the mean time, I'll keep you in my prayers as I pray for everyone on this site as we're on this journey together. God Bless & take care. Paula Open RNY 4/1/4 330/208/?

Thanks Paula, I appreciate the prayers. I will be seeing my PCP on 2/8. She will be writing a letter and fax to the surgeon's office. Yes, please do keep me in your prayers. God Bless, Sandy

Hang in there and fight! - as I know from your expressive icon that you will!- Stephanie J

Thanks Stephanie, I will.

Hi, Sandy! That stinks - 4 lbs short!!!! That is so not right! So basically, you'll need to GAIN 4 pounds, go to your doctor's office, get weighed in then have them fax that record to your surgeon's office and have them do the appeal. Or if your surgeon's office doesn't do appeals (mine doesn't) have your doctor make record for you and then send it in. But usually if BMI is over 35 WITH co-morbidities they approve, but insurance companies make you jump through SO MANY HOOPS! So not fair! I got denied because the insurance rep at my surgeon's office did a lousy job in sending Aetna the info. So I'm currently waiting appeal. (Check out "File sent to Dental Claims" post). I hope you get approved! God Bless! Trisha in Glendale

Thanks Trisha, yes that is exactly what I will have to do. Except for the 4lbs, It isn't anything that I would do on purpose, it just happens. Later and God Bless, Sandy PS I know you are going to get approved, just hang in there girlfriend.