Denied by UHC BMI not over 40 for 5 years

CHart6283
on 9/23/08 8:04 am - IL
I just received my denial letter from UHC and am upset. I feel as if I could burst into tears at any moment. I was really hoping this was going to happen for me. The reason stated was, I didn't have a bmi of 40 or over for 5 years. Does anyone know, do they really stick to the 5 year thing? My bmi 5 years ago was 36. I don't know what to do. I was thinking about trying to appeal it, but not even sure what to do or say. Any help would be greatly appreciated.
saletiajohnson
on 9/24/08 5:49 am - anchorage, AK

waht years was your bmi 40 and over? Because if you have 4 years and that one that was 36 was 5 years ago just wait till january and appeal.

acadiamom
on 9/26/08 12:12 pm
I feel your pain (and tears!!!)......I am in the same boat!  My surgery was supposed to be September 9th and it got cancelled just days before because UHC didn't approve.  You need to check your insurance coverage to see the specific requirements your company has with UHC.  Mine stated BMI >40 for 5 yrs OR >35 with any of the listed co-morbidities.  I also needed evidence of at least 6 months of a medically supervised diet or exercise program.  On my first appeal, my surgeon supplied a letter from my PCP with 5 years of weights and BMIs and a list of co-morbidities that were associated with my weight (2 of them were in the list from the plan).  He also supplied the 6 months of medical records from a medically supervised weight loss program I participated in 4 years ago at a local hospital.  I've been denied again and no one can figure out why.  The reviewer just keeps harping about the >40 BMI.  I've involved my corporate advocates group now to intervene since it appears UHC is in breach of their contract.  Hang in there and keep trying.....we need to keep pushing these insurance companies.....it's so STUPID!!!  The surgery pays for itself in a matter of a couple of years based on studies looking at improvement in medical problems......we don't need this!
CHart6283
on 9/26/08 12:34 pm - IL
You're right, I do need to check my insurance coverage. I hate calling there. I always feel as if they're judging me. Maybe I'm just being a little sensitive. But from everything I've read, there isn't really anything I can do. 5 years ago my bmi was 36. It's just continued to go up from there. This is the first time it's been 40. It's been 39 for the last couple of years. So, I guess I'm suppose to wait another 4 years and then try again. I can't stand being this heavy! It seems every diet I try, I lose 10 pounds and then gain 20.  Sorry to go on and on. I've been having a pity party since I received the letter. I wish you luc****ep pushing!
CHart6283
on 9/26/08 12:36 pm - IL
I don't know what happened to my last line. It was suppose to say, "I wish you luc****ep pushing!"
CHart6283
on 9/26/08 12:37 pm - IL
Ok, that is just weird. It looked fine on the screen and then it shows up the same way. Sorry
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