Insurance denied appeal

So, we have United HEalthare EPO and they wanted 5 yrs of documented weight and we sent it to them. Apparently in 2003 I had gone to the doctor once and wasn't fat enough. So they denie3d it. We appealed after I found a piece of immigration document with weight from another month which was definitely within the obesity range and they denied the appeal!!!

I cannot afford to pay a lawyer to fight this for me. What else can I do???

I am not sure, but I believe you should have another appeal.  Is your insurance through your employer?  If it is self-funded, you can appeal to your company.  I also have UHC and I am in the process of my second appeal (with my DH employer)  My case is a bit different, I have been approved for surgery, but not the surgery I want. (VSG) so I have to appeal their decision that it is experimental. Your denial letter (saying the denial was upheld) should have that info on it of appeal process, if it is available to you. Good luck to you!! Martha

They took 6 weeks to reply to our appeal when their denial letter had said they'd take 15 days. I am just worried they're delayign this and giving me the run around and I am getting more and more frustrated and depressed.  I am wondering if anybody has ever gotten their local government reps involved?

What do you mean by self funded?

Self funded plans have monies paid to the insurance directly from the employer, the insurance dispurses payments for your treatment to the doctors providing treatment. The employer has more say in what treatments will be paid as they are paying for your treatment. I dont know what state you are in but in California we do 2 appeals. If the first appeal is denied you may appeal again and state why you feel the treatment shoud be approved. The insurance must respond in 30 days (for PPO or EPO plans, 45 days for HMO). If your 2nd appeal is denied you may then file a complaint with the California Dept. of Insurance (ppo and epo) or Dept of managed health care for hmo's. They will make the final decision. In California we may do these appeals online.  So actually you do 2 appeals direct to the insurance and one complaint to one of the other state agencies. You may do this without a lawyer. Check online or in WLS books for assistance in writing your appeal, you will find basic formats to follow. Keep calling the ins. to follow up. I hope this helps. Kim B