Blsmbry

Like you Becca "Whatever it Takes" LOL

Tomrrow is the do or deny day for wls! I'll keep you posted as soon as I know something. In the mean time, I would like to thank all of you for your support and prayers and though I may not continuing posting if I'm denied but I surely will return when I get on the ban wagon to have wls! Tthanx! I love you guys!!!

Awesome! I am 32 yoa and have been researching wls every since 2005. I am employed with a company that covers wls. However, I have been denied twice. They say the 3rd tyme is a charm right? Well we'll just have to see about that. My consistency will pay off at the end. My ins company has everything that they need from me, physc eval, 5 yr weight history and some clinicals. my surgeon submitted the paper work on Jan 25 so I'm still waiting on the verdict. LoL Thank you for this thread I'll visit more often. Blsmbry

I'm like you oopsseedaisy, Im not sure but im hoping to have my date in March as well!

Wow! Congratulations!!

I am currently waiting to be approved for VSG. Like you, I too want to have kids. My thing is just like the others have said. I'm going to be successfuk in weight loss and go through my pregnanices and after I've had two then I'm going to get myself fixed up. So, if I were you I would wait until after you have kids like I would. Good Luck!!! Tootles!!!!!!

Your story is a great motivator!!

Your story is a great motivator! Good luck in your journey!

Hello, First of all I hope everything works out well for you. This insurance process can put you on a roll-a-coaster ride that will try to throw you if you're not strong enough. Hold on and don't give up. I was denied intial and was denied again because my 5 year history was not included. A couple of days ago my insurance re-submitted with my 5 year history for pre- determination so hopefully I'll be approve this time. Also I wrote my own appeal letter and I will like to share it with you. You can edit or add what pertains to you. Good Luck. Keep us updated! <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal>I am writing this letter to appeal United Healthcare decision to deny coverage for laparoscopy, surgical, gastric restrictive procedure that was denied. Based on the letter of denial dated December 22, 2010, this procedure was denied because “ the minimum of five year weight history was not met. Therefore, this service is not a covered benefit under plan. <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal> <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal>I was referred for this surgery by my PCP, who is very concerned about my health because of severe morbid obesity. I am a 32 year old morbidly obese female who is 5’4 iches tall and weigh 298 lbs., giving me a body mass index of 49. The body mass index is calculated by dividing a person's weight in kilograms by their height in meters squared. When a man's BMI is over 27.8, or woman's exceeds 27.3, that person is considered obese. The degree of obesity associated with a particular BMI ranges from mild obesity at a BMI near 27, moderate obesity at a BMI between 27–30, severe obesity at 30–35, to very severe obesity for patients with a BMI of 40 or greater. Therefore, I may be classified as being very severely obese. The annual number of deaths in America attributable to obesity has been estimated to be 300,000 deaths per year With my abnormally high BMI, I am at an estimated 190 percent increased risk of death at my present weight. <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal> <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal>After you reviewed my additional clinical information I know you have found to fact, that I have co morbidities of Obstructive sleep Apnea, Polyarthralgias, and Gerd. I have made many, many attempts to lose weight and this has gone on all my life. My previous over the counter weight loss aids, such as Slim Fast, South Beach Diet, Atkins, Hoodia pills, Alli, Slim Quick, and LA Weight loss was only a 5-10% success. I would lose some weight then gain it all back, and more. As you can see, I have spent all my adult life trying to lose weight. I am now at the point where everything is an effort. I have functional impairment in the activities of daily living. This dysfunction impacts sleep, recreation, work and social interactions. I am having significant adverse symptoms from my obesity. I have difficulty standing. I have difficulty performing my daily activities, and in participating with my family in recreational activities. I suffer from sleep apnea and acid reflux. I have arthritis and pain of my weight-bearing joints. An increase in body weight adds trauma to weight bearing joints and excess body weight is a major predictor of osteoarthritis of the knees. This is a mechanical problem and not a metabolic one. Weight loss will markedly decrease the chance of developing osteoarthritis. <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal> <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoBodyText>Both my PCP and I believe that laparoscopy, surgical, gastric restrictive procedure is medically necessary and will significantly benefit my health. I believe that laparoscopy; surgical, gastric restrictive procedure will increase my overall health physical, mentally, emotionally, and even finically. <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal> <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal>However, I have included additional clinicals that will show a history of morbid obesity over a five-year history. I have also included some pictures that will show a life long history of obesity starting from childhood. My prayer is that you will take into consideration to accept these pictures as a documented five-year plus weight history and reverse your denial to an approval for laparoscopy; surgical, gastric restrictive procedure. <P style="MARGIN: 0in 0in 0pt" class=yiv318147326v2> <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal>Economic costs of Obesity: Obesity has been shown to directly increase health care costs. In an article in the March 9, 1998 issue of the Archives of Internal Medicine 17, 118 members of the Kaiser Permanente Medical Care Program were studied to determine the association between body fatness and health care costs. The results showed that patients with BMIs greater than 30 had a 2.4 times greater risk for increased inpatient and outpatient costs than patients with BMIs under 30. <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal> <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal>Indirect costs: Americans spend an additional $33 billion dollars annually on weight-reduction products and services, including diet foods, products, and programs. Most of these expenditures, as is evidenced in this case, are not effective. Rather it can expected that they will continue to gain weight and the costs of co-morbid conditions, including the ones they already have and ones they surely will acquire as time goes on, will far outweigh the costs of gastric bypass surgery that we are asking you to please approve for me. <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal> <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal>As you can see I have exhausted all the traditional ways to lose weight. The gastric sleeve procedure (also known as laparoscopic vertical gastrectomy or laparoscopic sleeve gastrectomy) is an approved and proven means to permanently lose weight. Please approve this surgery for me by reversing your denial to an approval. I would like to thank you in advance for your time and effort in making this happen for me. Thank you very much. <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal> <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal>

I have UHC ins. in Florida. I know this may sound like a stupid question, But how do I go about by requesting and/or getting a case/ nurse manager to assit me in my approval process? Does it have to be a covered benefit or can I just request one? If so, how??? I would greatly appreciate your help. Thanx!!

I live in Florida and I have UHC ins. wls is covered but I have been denied 2 x. I'm in the process of re-submitting my 2nd appeal by the end of this month. Hopefully persistence will pay off!!1 I'll keep you updates. Good Luck Hello!! I have been doing some reasearch and was wondering if anyone had any luck with United Healthcare Insurance. I also would like some information on how to go about seeing if I am a covered candidate for VSG. Thanks, Margoboo

Wasn't aware. Very imformative. Thanx for the info!