appeal for history HELP

melisanmo
on 10/15/07 3:29 pm
I am so irriatated at United Health Care.   Has any one at all had the denial overturned after showing good reasons (dieting) why the whole last five years you didnt have a bmi of over forty??  PLEASE TELL ME ANYTHING.......  THESE GUYS TOOK 3 MONTHS TO DENY AFTER THEY VERBALLY APPROVED ME. MELISA
Talia
on 10/16/07 2:29 am - LA

did you have co-morbidities? If so your bmi could be between 35+ at least that is what BCBSIL thinks. what you may need to do is find out the criteria for obesity, then what is needed to have the insurance cover it....I hope this helps

Kahlua
on 10/16/07 7:36 am - NJ
Check the policy's writting. Does it say the "LAST" 5 yrs, or just "5 yrs" of meeting the NIH criteria for Morb Obesity? Do you have records of any 5 yrs (cummulative, here and there) of MO? If your insurance doesn't state the "last" few yrs, you can contest that any previous 5 yrs meets the policy's requirements. Sounds like they are trying to penalize you for trying to do something good for you health.  Good luck, Kahlua
heidig
on 10/25/07 3:04 pm
This is a good question, and one I could be facing soon.  I have only had insurance for 18 months, and the previous years rarely went to a doctor.  My BMI has ranged from 33 to 42 for years and years.  I've dieted, it goes down.  The minute I do not control every single bite, it sores back up with a vengence.  You all know this story.  Im getting ready to start my three months....but am worried the insurance will deny based on little medical history.
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