Proving 5 Yr History

JenE
on 1/19/08 3:20 pm - Sioux Falls, SD

Ok, I understand the need for long-term history regarding weight issues.  I understand that the insurance company simply doesn't want to approve WLS for just anyone, and needs to know that this has been an ongoing problem for several years.  I get that.  It's fine.  

But what about those of us who had a MAJOR lapse in medical coverage?  I was uninsured for the past 7 years, and have no OFFICIAL medical documentation of my weight.  Is there anything else they can use for "proof" of my weight history?  What about things like images or testimonials?  Or does it NEED to be medically documented proof of obesity?

 

Anyone know? 

"I'm a god. A small, fuzzy god." -- Queezy, my most beloved D&D Character.


 

Kahlua
on 1/20/08 2:39 pm, edited 1/20/08 2:41 pm - NJ
Yes, dated pictures, old driver's licenses or photo ID that could be verified by a date. Like a jon photo ID and a letter from your employer as to when ID pic was taken. Any gov't ID or document where you listed your weight. Pics from a wedding in which you can show proof of date (like your wedding pic--if married--and your wedding cert). Any life insurance applications, or physicals for jobs, etc. I may be difficult, and I don't think they would accept testimonials, unless maybe from a doctor who knew you during that time. This is an interesting issue, because it is sort of like the opposite of "pre-existing condition" clauses where they don't cover you if you had a condition before getting coverage. Here they WANT you to have the condition. Ironic, but understandable. However, these are rather discriminatory against the millions of people who had lapses in their inusrance or no insurance. They get you with pre-existing conditions (if a new policy has them) by penalizing you for a break in insurance beyond a couple of months), and they penalizing you now for not having insurance so you didn't see the doctor. For the working poor and middle class, this is a common occurrance. I wonder if would be considered destriminatory from a legal stance? I know, that's not something you want to take on/should take on. But if they deny you for that (or any reason that is stupid) make sure you send in an appeal and under your signature, clearly state that you are "cc" it to your State's commision board for insurance. If your ins is asking for an unreasonable proof that could be construed as discriminatory, the may see you've involved the state and approve it right away. Give them whatever proof you can (call and ask them what they'll accept) to show you are making every reasonable effort to comply. Then file a complaint with the state, and perhaps that will be enough to get them to approve you-- simply avoiding having a complaint listed against them with the State (state has to report complaints-- and the numbers are public). Now, they may still be jerks and deny it. They may be legally entitled to hold firm to their policy. But it's worth the try. Start with getting advice from them about what is acceptable, then start searching!! Even overload them with dated pictures. If you have 5 yrs of dated pics you should be fine. Usually they want at least 2 wts per year from medical notes (to make sure you didn't slip under the Morbid Obesity criteria for a secons), so they may want 2 pics per year. But depending on your wt, if your BMI is really high and you have pics a year apart, I guess you can make the arguement that there's no way you could have lost enough wt to fall out of MO criteria, then regain it in time for the next pic. Best of luck, Kahlua EDIT: I JUST READ YOUR PROFILE, AND YOUR BMI IS HIGH ENOUGH, IMHO, THAT 1 DATED PIC PER YEAR SHOULD BE FINE. iF YOU DON'T HAVE ALL 5 YRS (I DON'T THINK THEY HAVE TO BE CONSEQUETIVE, JUST TOTAL), SUBMIT AS MUCH AS YOU CAN AND HAVE YOUR CURRENT DOC STATE THAT THERE IS NO WAY YOU COULD HAVE LOST/REGAINED ENOUGH WT DURING WHATEVER GAPS IN PROOF YOU HAVE. GO GET'EM GIRLIE!!
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