CoolBrze198

Thanks again for the new replies...I will be looking at a coworkers benefits books tomorrow if she remeber to bring it to work. I have been searching for the letter I got a while back that I think put WLS as an exclusion. But for the life of me cant find it. If for some miracle that the WLS wasn't excluded and I was denied last year, then my appeal was denied as well. Do you think I should resubmit everything again has it been to long for me to appeal again??? My 5 years should be up early next year. *fingers crossed* that the exclusion was a figment of my imagination.. lol Will keep you up to date on what I find out. And thx for all your replies,

:smile2: Thanks for your replies.. I guess I will stick with what I have. I was denied for WLS due to not having 5 years of BMI of 40+ I had just over 3 years. Then it seems like not long ago (within a year) I got like an update to our coverage book that WLS was excluded. I have UHC Choice with my husbands work. My work also has UHC, but not sure of the plan. I even thought maybe switching to our insurance. I will get a benefits book from a co worker and see if there is an exclusion. If no exclusion and I should swithc ( just a thought here) How long should I wait before atempting to even try to get approved? Or should I just face the facts that I will not be able to have surgery unless I save the $$.

I started the process year before last. But UHC denied me. And then denied my appeal. So I gave up... :smile2: I am thinking very seriously about findind new insurance. So, I am asking for any help on who to chose and what plan. (I am health insurance illiterate) I would like to find someone to cover this and the premiums not be thru the roof. Any suggestions you can give will be greatly appreciated !!! TIA, Rosanna

Hi Pamla, Well I did it. I think it said in my denial letter that when you appeal you should have an answer within 15 days. So here I am waiting again. Wish me luck.

Hi Ragdoll, I faxed in my appeal letter last wednesday. I am keeping my fingers crossed. I have a gut feeling that I will be denied again. But hey, you never know. I copied a letter off of a yahoo group. Of course I changed it to fit me. So of course I am hoping whoever gets it is empathetic with me. Please keep your fingers crossed. How have you been?

Hi Pamla I haven't started the appeal process just yet. I just got my denial letter in the mail a few days ago. I have been doing some research on what to say in my letter and what else I should be doing. How have you been? KIT

Could you send them to me as well? Please. Grrrr.. I am so angry. I was told that I didn't have a BMI of 40 or more for 5 years. Which I knew I didn't. But I have had 40 BMI for the last 3 years and as they can see if they looked thru my past 5 years of medical records that I can lose but I can't keep the dern weight off. So I will be appealing. Anyone have a situation like mine & appealed and won?? TIA, Rosanna

Grrrr.. I am so angry. I was told that I didn't have a BMI of 40 or more for 5 years. Which I knew I didn't. But I have had 40 BMI for the last 3 years and as they can see if they looked thru my past 5 years of medical records that I can lose but I can't keep the dern weight off. So I will be appealing. Anyone have a situation like mine & appealed and won?? TIA, Rosanna

Grrrr.. I am so angry. :fish: I was told that I didn't have a BMI of 40 or more for 5 years. Which I knew I didn't. But I have had 40 BMI for the last 3 years and as they can see if they looked thru my past 5 years of medical records that I can lose but I can't keep the dern weight off. So I will be appealing. Anyone have a situation like mine & appealed and won?? :help: TIA, Rosanna

Well I called UHC again today and was told it was still in review. And the lady I talked to couldn't believe it is still in review since it was submitted on the 19th. So she put a rush on it. So I will try them again on friday. Good grief! Come on and approve me already. Will post if I hear anything else!

Yeah Ragdoll.... I am so happy for you. :clap2: :clap2: :clap2: :clap2: Hopefully I will be right behind you... When is your surgery date? Keep us posted on your progress.

:phanvan Well, I called UHC this am and gave them my reference #. They told me my paperwork was with the nurse for review.... I asked when they got the paperwork. And she said on the 19th. Dern how much longer is it going to take. Read my reports already!!! My tentative surgery date is May 22nd. "That date is contingent on hearing back from UHC with an approval prior to May 7th." That is what my surgeons office told me... So, I am patiently waiting... Well make that IMpatiently waiting... :phanvan Will post more when I have some news... Hopefully good news in the next couple of days... Good luck everyone else!

Hi Everyone, I was curious... May paperwork has been submitted to my Ins Co. for approval. And I want to take some before, during & after pictures as well as my measurements. What my question is.. Is there a certain outfit I should take these pictures in? Like jeans & a t-shirt that fit now, shorts & tank? Or should the clothes be different? I want to wear something that shows my actual size. You know clothes can hide our weight. (Somewhat).. LOL TIA,