Denied UHC!! ***in tears***

[sweetiepie01 0]

HI Everyone! Im new to this forum but I've been being nosey for awhile reading through the post. I was just denied for my VSG and Im crushed and dont know what to do. They denied me because in 2007 my BMI was a 39. I cant believe it!! Im crushed! Im going to appeal but really I dont know where to start and what documentation I can include that would get me overturned. If anyone has experienced this please help me. My insurance is UHC. Thanks

[thinoneday 445]

Your lucky the UHC at least looked at it, I have UHC and bariatric surgery of any kind is NOT covered by it on our end. . I was self pay. . . yup took out a loan . . . but hey I really wanted this surgery so I did whatever I had to. . yes I still have a ways to go to repay it but oh well. . . I got to goal before the loan was paid for! Self pay could be another option.

[Ms. E 5]

HI Everyone! Im new to this forum but I've been being nosey for awhile reading through the post. I was just denied for my VSG and Im crushed and dont know what to do. They denied me because in 2007 my BMI was a 39. I cant believe it!! Im crushed! Im going to appeal but really I dont know where to start and what documentation I can include that would get me overturned. If anyone has experienced this please help me. My insurance is UHC. Thanks

I am so sorry, we have United also and they approved me but not my husband, he as you had a BMI of 39 in 2007. Now things have changed for us, in 2008 my husband broke his foot, he has since had 3 surgeries on the same foot, not to mention a very bad knee therefore he cannot exercise and even walking is painful. He needs this surgery to save his life and they denied him. I was also crushed. He has gained over 80 pounds in these past years. We tried disputing it to no avail. We are thinking about either self pay or waiting until open enrollment comes around and changing to Aetna. They only go back 2 years for BMI history.

Good Luck and hang in there.....where there is a will there is a way.

[Oopsseedaisy 90]

I have UHC but did not need the five year weight documentation. I had it so we sent it in anyway. If they are looking for a 5 year history, you can appeal or try again in Jan 2012. That way you no longer need 2007 BMI to qualify. They are not looking for 5 full years just a date at sometime in the calendar year(2008, 2009, 2010, 2011, 2012). I hope that makes sense. I know once you make the decision you are ready to take action, but it is an option.