smylie1 0 Posted November 6, 2007 OK, I have been on this yo-yo for years! I have had a bmi over 40 then lose a little weight and it would go down, only to gain it back months later. I have done the pills/shots/ combo., Nutrisystem, Atkins, Phentermine, Merida, and Xenical, but I don't have 5 consecutive years worth of 40+ documentation! I am now at a 42 BMI. Here's my question. I have been diagnosed with HBP. I have fascitis in my feet and cannot walk for exercise without agrrovating it, and I'm pretty sure I have sleep apenea, though I've not been diagnosed. Do you think my insurance will approve without the documented history of a 40 BMI? Share this post Link to post Share on other sites
kagoscuba 0 Posted November 6, 2007 It depends really. I was denied by Horizon with two diagnosed co-morbidities: HBP and sleep Apnea. I submitted everything anyway, and so far they've paid for my first fill, 40% of the anesthesia bill, and my doctor fee and hospital bill are pending. Share this post Link to post Share on other sites
Flowerpurr 0 Posted November 6, 2007 I have the same problem with the history. I have about 8years worth but I am missing one year to complete a full five. I to can't exercise because of my foot. All I can tell you is if you have pictures with dates on them you can use those. Otherwise submit what you do have and pray really hard! Share this post Link to post Share on other sites
destiny79 0 Posted November 6, 2007 I am having almost the same problem I have records from 2002-2005 missing 2006 but have 2007 so my Dr. office told me to write a letter explaining why I don't have 2006 so far I have not heard anything yet I have UHC insurance. I called them they said they're trying to make sure you did not gain the weight in 1 year just to get the lapband so any five years is OK it can be split up but I'll let you guys know what happens:kiss2: Share this post Link to post Share on other sites
Flowerpurr 0 Posted November 7, 2007 Tomecia that is great news!!! I was worried. I have records from when I was 21 and was really big. Bigger than than I am now! But you just gave me lots of hope!!! Thank you! Share this post Link to post Share on other sites
Motocrossgirly 0 Posted November 7, 2007 Hi, I have essentially a very similar history & I submitted to United Health Care POS and I was approved! I haven't set my surgery date, but will do that on Friday 11-9-07! YEAH! Share this post Link to post Share on other sites
destiny79 0 Posted November 7, 2007 motocross how long sis it take for you to get your approval ? I have uhc choice plus, my info was submitted yesterday Share this post Link to post Share on other sites
Motocrossgirly 0 Posted November 7, 2007 Hi, It was 10 days from submission to approval, another 7 days to actually receive the letter in the mail. :-) Share this post Link to post Share on other sites
antsmith101 0 Posted November 7, 2007 Motocrossgirly did you also write a letter stating that you missing certain year? and if you did can you provide a sample letter? thanks Share this post Link to post Share on other sites
destynee990 0 Posted November 7, 2007 Wow! I have UHC too and I was told that they are the "easiest" to approve!! I have also had weight issues for at least 5 years but never got to a BMI which was high enough to qualify for surgery! The nurse in charge of submitting the request for approval told me that if my BMI changed to come back in. I am guessing that was her way of saying gain some, SO now I am 10lbs from a 40 BMI sched, for my Psyc eval. on the 19th!! that would suck to do all this and have them say No because I "SUDDENLY" shot up to a 40BMI! Please let me know what happens! Share this post Link to post Share on other sites
Motocrossgirly 0 Posted November 8, 2007 Hi, I never wrote a letter explaining the missing year (it was related to a move from CA to GA); but, instead I provided an additional previous year, ex.. instead of 2002 through 2007 I did 2001, 2002, 2003, skip 2004, 2005, 2006, 2007. Share this post Link to post Share on other sites