Five year documented weight history question

Hello, this is my very first post.. I have a question for anyone that will listen. I've been considering gastric bypass for a long time and I finally have a new job with insurance and I've got to a great place in my life and I felt like now is the time. I went to a seminar and it was incredible, positive and informative. I happily started filling out my packet the next day and started to try to line up appointments.

Then I got the call about my insurance. I had no idea about the 5 year documented weight history that would be required. That is the only thing holding me back from insurance helping me with the surgery. I lost my job a few years ago which meant I lost my insurance.. when I got sick? I toughed it out and never went to a doctor. I have no records of being weighed, not from a doctor, walk in clinic, ER, etc. Literally, a $20,000 mistake. I was quoted $4000 with insurance after meeting requirements. Self pay would be $24,000.

I am absolutely crushed. I've been crying for days. I'm keeping the appointment I have next Friday with my MD, I am going to ask her if she will send a letter of Medical Necessity. I feel in the back of my mind that it won't work and they won't approve it.

Have any of you had this happen? Or had a letter of Medical Necessity work for you?

Any advice would be greatly appreciated. Thank you so much.

I'm not sure which insurance you have but don't give up hope my insurance really took a statement from me and my surgeons office of what diets I had been on in the past 5 years.. I had a horrible time when I first started trying to get approval due to me having 2 insurance policies at that time it took me few months to figure out what needed to be done and now I'm approved with a December date... Have faith

I'm right there with you on that one. I only have two of the five years documented. My surgeons office coordinator doesn't seem like she has a lot of hope. At this point I am still pressing onward with all my appointments and pre-op tests. and if it means a medical loan, then so be it.

I'd be broke with bills than live another year like this.

Lots of luck to you!

I also had to have 5 years back on weight, I had 5 years, 2  years, 1 year and of course current. I did not have the years for 3 and 4. The insurance company approved it even missing those years due to the fact I just didn't go to the doctor. Perhaps see what you can get if possible since you did stated it was a couple of years ago you did not have insurance.. but did you have it back say 3, 4 or 5 years back??   It is worth a try.. Hope it helps..

 

 

 

I am in the process of approval. My insurance required 5 year history also (BCBS Tennessee). I needed weights from 09-13, but I only had '10, '12 and '13. Luckily, I found a fitnessgram I did in high school back in '08. My Dr.s office explained how the majority of teenagers or young adults really never go to the dr unless something is wrong. My case manager ended up waiving the weight requirement for me. Unfortunately, I'm still waiting due to my psych not scoring my test and including it in the notes! THEN he had the nerve to go to Austria for a month! THE NERVE! Good luck, it is possible