sems10909

Hi There, I know you posted this a while back, but I was just denied by UHC for lap-band. My policy states I need a BMI of 40 or over OR a 5 year history of morbid obesity. I am over 40 BMI but only have 4 yrs of morbid obesity and was just under 40 on the fifth year. I appealed twice since it states I need either BMI 40 OR 5 yr history- but they advise due to a typographical error (on their part) it Should say "and", so they wont cover. I have retained an attorney who feels I have a very good case, I work in the insurance industry myself so I am very fimiliar with reading a plan. I was wondering if your case is similar to mine, I'm looking for others who have been denied for a similar reason. Thanks for your time Suzanna

Hi All, This is my first time here, I am a 36 Yr old Female who has been overweight for many years. I have tried many diet and exercise programs including Phen-Phen, JC, WW, NutraSys, Atkins, The Cleanse Etc...I have had gym memberships with 5 different gyms, and I've tried the watch what you eat and walk everyday program. Problem is my body needs intensive exercise 7 days a week along with writing everything I eat down and restricting my calories to unreasonable amounts, just to lose a small amount of weight. I'm tired of fighting with my weight. I had a serious accident 3 years ago that has left me with 2 buldging disc's in my lower back, so now exercise is more painful then usual. I have been denied by United Health Care for the lap band due to a typographical error (on their part). Per the policy language I qualify for the surgery, I have sent 2 appeals to the denial showing them in their own policy where it states that I would qualify. Their anwer? Oh sorry its our fault that this error was made, but we are still not going to cover this for you. I have retaind an attorney who is taking my case, and feels I have an excellent case with all of the evidence I have provided. I am looking for anyone who has been denied bariactric surgery by UHC, I would like to talk with you and see if this has happened to anyone else. I live in the San Diego area and was seeking surgery through Sharp with Dr. George Mueller. Please respond to me as soon as possible if anyone out there has had a similar situation. Thank You Suzanna