So, what do you think....????

[Margoboo 0]

Ok, I have UHC insurance. In February 2010 I was denied by my insurance company for surgery because I only have 3 years of documented bmi over 40. The other 2 years, I was on prescribed diet pills and by bmi was 34-35..... I was sooooo DIASPPOINTED!! I have since gone to an Intertist and I had a sleep study last night and I passed with flying colors. I most defeintly have sleep aptnes. My blood pressure was slightly elevated on my last dr. visit, as well and he is going to monitor it next month. Do you think I will be approved since I have a diagnosis of sleep aptnea and a possibility of high blood pressure. What do you think??

[MINI-Me 196]

It never hurts to try. You will have a better chance if you can document the high bp.

[LovinLife 0]

I have UHC and was approved in June. I only had 2 years of documentation of 40+ BMI and I provided photographs for the other years. I was also diagnosed with sleep apnea in May and I'm sure having any co-morbidity will be in your favor for approval. Having sleep apnea with a BMI over 35 and high blood pressure should help you. Go for it!

[mila1013 0]

from what you have posted, it does not seem you will qualify, to have wls for bmi 35 you usually also have at least two of:

1. Clinically significant obstructive sleep apnea (i.e., patient meets the criteria for treatment of obstructive sleep apnea or
   
2. Coronary heart disease; or
   
3. Medically refractory hypertension (blood pressure greater than 140 mmHg systolic and/or 90 mmHg diastolic despite optimal medical management); or
   
4. Type 2 diabetes mellitus
   

while ever insurance plan is different, I have never heard of having to show 5 years of bmi over 40, bmi 35 yes, but over 40 no. the surgeon can help you with this, s/he knows your medical history....sending you good thougths

[cwalker 12]

What are the requirements for your UHC? The sleep apnea and HBP will sway the odds in your favor, so try don't give up!

[LovinLife 0]

Yes, requirements vary for each insurance company but my UHC Choice Plus did require 5 years of documented weight history over 40 BMI. Your surgeon's office should be able to help you!