Freaking Out-Need Prozac or Advice

OK,
Im lost-Im just finishing up with my 6 month program with my Doctor and Nutritionist. The insurance company (Aetna) is requiring 2 years of obesity history. I started my 6 month program in Jan 08 prior to that,  I haven't seen the doc for 2 years.  I have 2008 covered (Jan), my question is, do you think I will be denied If I file in Jan 2009 ?? Feb?? March?? Is 2 years 2008, 2009 ir is it 365 X2 (730) DAYS. I hate numbers

BMI over 53.9 for 7 years with  diabetes and high blood pressure


Pete

You should be able to use a doc visit over 2 years ago, unless they want to claim you lost 100 pounds and gained it back again. And even then, it would just prove you can't keep it off without surgery!

After looking up all my info this is what I came up with.

I found history for doc. visit for 2005 my weight was 315 (WRONG)  Nothing for 2006,2007 Prior to that I have many documents from 2002 to 2004. The problem is the scale ot the office only went to 350lbs I TYPICALLY weighed 400 to 420 for the last 7 years. The weight was always left out due to that fact the cant weigh me properly, or as the above example, just a quess. Stuck and scared 

Pete

Don't be scared.

If your doctor's scale only went to 350, then when he submits the weight history have him note 'patient's weight unknown, scale only went to 350 and patient was more than that.' Heck, even 315 is obese, PLUS you have co-morbidites. If your doctor submits the paper work right, then you will get approved. If not, fix the paperwork and win on appeal. But I don't really think you have anything to worry about!

Given that your BMI is over 50, yours is not really a close call....our experience handling hundreds of similar Aetna cases is that if you can go a bit further back showing weight history that is consistently over 45-50 as you indicate, they should approve either on the first submission or on appeal.
Good luck.
Walter Lindstrom
www.obesitylaw.com