Almost there.. Insurance/Recovery question?

[sleevedtbd 10]

Hello All,

I have been a long time lurker on here, soaking up information. This forum helped me make this decision, and over the last couple months I have been working through the process.

Stats:

Age - 25

Gender - Female

CW - 243

So far I have completed all of my doctor's and insurance requirements.

- Initial Consultation

- Psychological Evaluation

- Gall Bladder Ultrasound

- Endoscopy

- Met with Dietician

I have United Healthcare Choice Plus through AT&T's management plan - 80%/20%. They require a BMI of 40 or a BMI of 35 (with 2 comorbities). They also require 5 years of documented weight history from a physician.

My only hang up is the 5 year weight history. I don't have a primary care doctor, nor any documentation from any other weight loss programs, period. All my weight loss efforts have been private. My advocate stated she could get some weight "guesses" from me and have the doctor sign off and submit that, and hope for the best. She says she has had success that way in the past , but with UHC it's hit or miss based on your case worker.

My questions are:

1. Do I have a shot with her doing that, and is it a slim chance. Specifically, if you have UHC.

2. Do I have other options or "ways" to show my BMI over 40?

3. If I have to self pay, do hospitals/doctors accept payment plans?

Any comments, ideas, advice, and experiences are welcome.

Thank you!!!

[jane13 2,256]

@@sleevedtbd - do you have regular yearly gynecologists appts? They should have documented your weight. If you are on BC it use to be brought up (weight) years ago when I was going. At the time I was not overweight but my GF was and she was seeing the same doctor. You didn't show your height but if your BMI is under 40 you may want to also see if you may have comorbidities like if your BP was a little higher...are you pre-diabetic...do you have sleep apnea? That was a concern for me as my BMI was just over the minimum. I am a lot older but they also said my HBP and pre-diabetic state would override the BMI. I also thought I was 5'8" and some change...turns out I am now just UNDER 5'8" so if they listed me as 5'7" my BMI was actually higher...

[sleevedtbd 10]

@@jane13 thanks for responding!

I go every 2 years. My doc from 2011 doesn't have the record anymore. Waiting to hear from doctor on 2013 (moved to Texas in 2013, so different doctor). There is also the possibility I was under the 40/35 BMI range, so it may be a double edged sword. No comorbidities that would count according to my doctor (lifetime history of Ashtma and Psuedotumor Cerebri). I guess at this point I may just have to play the dreaded waiting game. ????

[jane13 2,256]

@@sleevedtbd - What about other visits to the doctor? ER appts, sick appointments, asthma issues...

Did you go to weight watchers? or another place where you weighed in to lose weight....gym?

[sleevedtbd 10]

@ non at all.