denied need help

Michelle B.
on 3/25/08 5:24 am - Augusta, ME
I was denied by Fiserv Health because my "BMI was not over 40 for the last 3 years"  It has been 36 to as high as 40.  My insurance plan document does not state that you have to have BMI greater than 40 for 3 years.  I was told by insurance that "it is a general guideline"  My surgeon's office has never had this happen before.  If I appeal do I stand a chance?  How can they deny me for wording that is not in my plan?
Shelly H.
on 3/29/08 2:56 pm - Norman, OK
Most insurance covers for BMI of 40 or greater, or a BMI of 35 or greather if you have 2 co-morbid conditions. If you have 2 co-morbid conditions and a BMI > 35, I'd definitely appeal!
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