UHC denial

I have UHC secondary to Medicare.  I received a denial based on the 5 year weight history. They  said I didn't .have a 5 yr history of morbid obesity. I have a BMI of 42, this year and last year, the other years were well above 35. I also have had 3 knee replacements, and a hip replacement. I  lost one of my knee replacements and obesity was implicated in that failure. I have hi BP,  hi cholesterol, severe arthritis, back pain, GERD, and fibromyalgia.
according to NIH, a BMI over 35 with comorbidities is morbod obesity. Is this correct. Does anyone have any suggestions for my appeal? Thanks in advance.  AT

Www.kindi.myvi.net. 8 weeks ago I was 365 pounds and my blood pressure was 144/103. 2 filling shakes (breakfast/lunch) with two snacks and a healthy dinner a day i'm now down to 329 and blood pressure at 123/73 and i'm a truck drive so i'm not killing myself on a treadmill for those results. Hope this helps.

Jeff, you are doing great!  I started a higher protein low calorie diet myself today. I t includes 2 shakes, a little fruit, chicken or tuna . I hope I can lose at that. While I am able to walk, and exercise in a pool, my joints still prevent a lot of exercise. I hope i do as well as you have done. Thanks for the reply and continued luck to you!! A.T.

If they require 5 years of obesity history, you need to go back to your PCP and gather the records necessary.

If it has not been 5 years, you may need to work on an appeal, or document as far back as you can and then wait until you meet their criteria.

I have UHC, but a Bariatric exclusion -- so I had to self-pay for my surgery.

I had UHC, with a bariatric surgery exclusion as well.... however I appealed and won.  My surgery was paid for 100% (after my $300 deductible)

I had to pay out of pocket for 5 years worth of medical records from my Primary Dr, AND my OBGYN.  It was worth the $80 I paid for the records (they charge to copy).

APPEAL it!!  And make sure you state the facts.  NO opinions, and no "I feel"...   If it's too long, they wont even fini****  Get to the point.

Also - see if your doctors will write appeal letters, or recommendation letters on your behalf.  That worked for me.

Good Luck!!