5 year history

[ccbcdeke 11]

My insurance requires a 5 year history of obesity. I was assuming that meant the minimum BMI to be classified "obese". But the surgeon's office says it has to be a 5 year history of over a BMI of 40.

I don't go to the doctor very often (typical male). So my weight checks are very limited, one per year if I was lucky. Well, my BMI was 40.1 in 2006, but it dropped to a low of 34.7 in 2007. In '08 it was about 35.9. By '09 and '10 I had a BMI over 40 again. So minus those two freak years, it has been over 40 for the past 5 years.

I hope they don't give me any problems approving surgery because I had temporary success doing Weight Watchers.

What have you experienced with United Healthcare that requires a 5 year history?

I go April 12th for my "intake" appointment. Should I wait until then to take my weight checks to the surgeon’s office or send them on ahead of me? I would hate to spend the $250 fee if I am not going to get approved.

Thanks for reading this long, rambling post.

Jim

[KinkySlinky 3]

Check with UHC and see if you can provide 7 years of weight logs because you did not seek treatment for two years... Unless you had UHC during those two years, then they will be able to tell..

[ccbcdeke 11]

Yeah the lady at the surgeon's office said that she had just sent a packet for approval for someone that has the same insurance as I do and works for the same company. She sent theirs without the 5 year history. she was going to let me know if that one got approved or not. I think I will send her my history and see what she says. Maybe I will need to cancel my appointment if she doesn't think it will get approved.

My wife is working through a different surgeon. Hers has said that she needs two weight checks for each of the 5 years. If that's the case, I'm screwed. However, they also told her that she had to do a 6 month supervised diet. We called and talked to a coordinator and they told us that they we do not have to have a 6 month diet. just the 5 year history.

[kalfin13 4]

I have UHC and did not have the 40 bmi for 5 years. I also submitted to my coordinator seven years history because there was a year in there that I did not see a Dr. and another year I only saw the Dr. for pregnancy (fortunately it was with twins so I didn't have a problem eating my way to "morbidly obese" status). I lost a pretty good bit after delivery and was only at a BMI over 40 for the past two years. With all that they approved me, so hopefully they will do the same for you. Good luck.

[ccbcdeke 11]

I have UHC and did not have the 40 bmi for 5 years. I also submitted to my coordinator seven years history because there was a year in there that I did not see a Dr. and another year I only saw the Dr. for pregnancy (fortunately it was with twins so I didn't have a problem eating my way to "morbidly obese" status). I lost a pretty good bit after delivery and was only at a BMI over 40 for the past two years. With all that they approved me, so hopefully they will do the same for you. Good luck.

well that certainly is a boost to my confidence. Thanks for that.

[fatBgone 6]

well that certainly is a boost to my confidence. Thanks for that.

I have UHC and I was declined because of BMI BUT I really think its dictated by your company who funds the insurance. UHC told me that its my company who sets the rules--5yr history of BMI over 40. So I am now a self pay. Good luck to you.

[KinkySlinky 3]

I really think its dictated by your company who funds the insurance. UHC told me that its my company who sets the rules--5yr history of BMI over 40.

This is correct.

[ccbcdeke 11]

Now see...you guys are not helping my confidence. But thanks for your honesty. I work at UPS...hopefully I will get approved.