Question:
insurance United Healthcare denied my request for LAP BAND and I am nervous

My insurnace company, United Health, denied my request for LAP BAND due to the fact I dig not have BMI of 40 for the last 5 years, but I have been over BMI of 35 for the last 5 years with depression, hypothyroidism and I was diagnoised with sleep apnea this year. My surgeon's RN did not include the paper work stating I have sleep apnea with original request because she said it was not needed and if it was denied then she would send it...I am very nervous RN does not know what she is doing. I have contacted Obesity Law and they have accepted my case, but I am still nervous that I will not be approved. Any suggestions????    — dragonfly_girl (posted on August 12, 2009)

August 12, 2009
It just depends on the type of coverage and the size of the company with the insurance. I have United Health, and though I had a BMI of 55, sleep apnea and high blood pressure, and had for over 15 years, I was denied, supposedly because of the size of my husband's company (around 130). My husband's company insurance guy went to bat for me, but the final word from UH was, and I quote, "No way in hell." But please don't despair. It took me 3 years to get my surgery, but I did find a way...you will, too. (I saved some and took money out of retirement; my girlfriend got a personal loan from her husband's boss.) Just don't give up. May God bless you.
   — jtoothman

August 13, 2009
You are in control of this situation. Tell the RN she needs to resend all of your paperwork stating all of your co morbidities. That is there job, as the bariatric surgeon's nurse is to make sure all the correct forms are filled out. But having depression, and hypothyroidism won't get you an approval. Sleep apnea will though. Just stay on the nurse and tell her you want a copy of all the times she submits it. Don't give up, but I don't think you quite need an Obesity Lawyer to help you win. Just the sleep apnea alone should do it. That is considered a life threatening issue. Maybe just use the Ob Law to help you with the nurse. Hang in there, it will or could take awhile.
   — Kristy

August 13, 2009
If you are in with ObesityLaw, then you won't lose, trust me, they just don't lose! Insurance companies don't like hearing from them, because they know they will not win against that guy, he's very very good!
   — eyeflirt4fun